糖尿病患者行白内障超声乳化术后黄斑区视网膜厚度的变化

Macular foveal retinal thickness changes after phacoemulsification in diabetics patients

目的观察2型糖尿病患者行白内障超声乳化术后黄斑中心凹视网膜厚度(FRT)的变化。方法选择2017年1月—2017年9月在蚌埠医学院第一附属医院眼科行超声乳化白内障摘除及人工晶体植入术的患者60例,其中2型糖尿病合并白内障患者30例(30眼)为糖尿病组,年龄相关性白内障患者30例(30眼)为对照组。术前、术后1 d、1周、1个月及3个月分别利用光学相干断层扫描(OCT)检查黄斑中心凹视网膜厚度(FRT),分析手术前后2组间及组内黄斑中心凹视网膜厚度(FRT)的变化。结果糖尿病组:术前及术后1 d、1周、1个月、3个月黄斑中心凹视网膜厚度(FRT)分别为(216. 24±19. 44)μm、(216. 20±18. 94)μm、(216. 94±19. 00)μm、(235. 17±24. 42)μm、(227. 52±25. 36)μm;术后1周、1个月、3个月黄斑中心凹视网膜厚度(FRT)均较术前(216. 24±19. 44)μm增加,差异具有统计学意义(均P <0. 05);术后1个月达到最高值(235. 17±24. 42)μm,至术后3个月稍有下降,仍高于术前。本组中有5例(16. 67%)发生黄斑水肿。对照组:术后1 d、1周、1个月黄斑中心凹视网膜厚度(FRT)较术前增加,术后3个月FRT较术前略下降,但差异均无统计学意义(均P> 0. 05),无黄斑水肿发生。术后1个月、3个月,糖尿病组的黄斑中心凹视网膜厚度较对照组增加明显,差异具有统计学意义(均P <0. 01)。结论糖尿病患者行超声乳化术后,黄斑中心凹视网膜厚度增加显著,黄斑水肿的发生率较高。

Objective To investigate the changes of macular foveal retinal thickness （FRT） after the phacoemulsification and intraocular lens implantation in type 2 diabetics patients. Methods A total of 60 cases of cataract with phacoemulsi- fication and intraocular lens implantation were recruited. Thirty cases of 60 Patients with diabetics were in diabetic group, and others with age-related cataract were in control group. FRT were measured by using optical coherence tomography （OCT） before phacoemulsification and 1 day, 1 week, 1 month, and 3 months after the surgery. The changes of FRT were compared in the two groups. Results In the diabetic group, the preoperatively mean fovea thickness was （216.24 ± 19.44） μm, and postoperatively mean fovea thickness was （216.20 ± 18.94） μm at 1 day after the operation, （216.94± 19. 00） μm in 1 week after the operation, （235. 17 ± 24.42） μm in 1 month after the operation, and （227.52 ± 25.36） μm in 3 months after the operation. In 1 week, 1 month and 3 months after the operation, the difference in FRT was significant（ all P 〈 0.05 ）. In the control group, the FRT was thickened at 1 day, 1 week, and 1 month after the surgery, which decreased slightly at 3 months after the surgery, but with no statistical difference （ all P 〉 0.05 ）. The difference of the mean fovea thickness between the two groups at 1 month and 3 month after surgery was significant （ all P 〈0. 01 ）. Macular edema was found in 5 eyes （5/30, 16.67% ） in the diabetic group, and none （0/30） in the control group. Conclusion The thickness of the fovea of retina increases significantly after phacoemulsification in diabetics and the morbidity of macula edema increases as well.