糖尿病白内障手术前后黄斑区厚度的对比观察

Comparative Observation of the Thickness of Macular Area before and after Diabetic Cataract Surgery

目的通过光学相干断层扫描(OCT)观察合并糖尿病与非糖尿病白内障患者术后黄斑厚度的变化。方法选取2018年3—8月在德州市优抚医院眼科行白内障手术患者138例(138眼)作为研究对象。排除标准:术前白内障较重无法完成OCT检查者;术前有明确眼底疾病等其他可能影响视力的混杂因素。根据是否合并糖尿病分为两组,糖尿病组45例(45眼),非糖尿病组93例(93眼),采用OCT测量两组患者术前、术后1 d、术后1周以及术后1个月时黄斑中心凹厚度的变化情况。对于各组不同时间点的黄斑中心凹厚度进行χ~2检验,分析不同情况下黄斑厚度的变化情况。结果非糖尿病组术后1 d、1周及1个月的黄斑区厚度与术前比较,差异无统计学意义(P>0.05),糖尿病组术后1周、1个月黄斑区中心凹厚度与术前相比,差异有统计学意义(P<0.05);两组术前和术后内环区、外环区视网膜厚度对比,差异无统计学意义(P>0.05)。结论手术后糖尿病患者中心凹区视网膜厚度变化显著,提示糖尿病视网膜病变是引起白内障术后黄斑水肿的一个重要因素。

Objective To observe the changes of postoperative macular thickness in patients with diabetes mellitus and non-diabetic cataract by optical coherence tomography(OCT). Methods From March to August 2018, 138 patients(138 eyes)with cataract surgery in the ophthalmology department of Youfu Hospital of Dezhou City were selected as subjects. Exclusion criteria: preoperative cataract heavier and unable to complete OCT examination;preoperatively, there were clear confounding factors such as fundus diseases that may affect vision. According to whether or not diabetes was divided into two groups, 45 patients(45 eyes) in the diabetic group and 93 patients(93 eyes) in the non-diabetic group. The patients in the two groups were measured by OCT before and after surgery, 1 day after surgery, 1 week after surgery, and 1 month after surgery postoperatively of the change in the thickness of the fovea. The χ^2 test was performed on the thickness of the foveal fove at different time points in each group to analyze the changes of macular thickness under different conditions. Results There was no significant difference in the thickness of macular area between 1 day, 1 week and 1 month after operation in non-diabetic group(P>0.05). The thickness of fovea in macular area was 1 week and 1 month after operation in diabetic group. Before the difference, the difference was statistically significant(P>0.05). There was no significant difference in the thickness of retinal between the two groups before and after operation(P >0.05). Conclusion The thickness of retinal changes in the fovea of diabetic patients after surgery is significant, suggesting that diabetic retinopathy is an important factor in causing macular edema after cataract surgery.