糖尿病合并眼底病患者白内障术后黄斑水肿和视力刍议

Discussion on Macular Edema and Visual Acuity after Cataract Operation in Diabetic Patients with Fundus Disease

目的明确白内障术后,患者术前出现黄斑水肿以及视力变化情况。方法该次研究选取2017年5月—2019年6月于该院收治的70例糖尿病合并眼底病患者作为观察组,所有患者均实施白内障术,选取未合并糖尿病眼底病变的白内障70例作为对照组,针对患者术后的黄斑水肿和视力情况进行对比与资料分析。结果术前、术后2周、8周和6个月中,观察组患者的视力<0.1,分别占34.29%,视力>0.1分别占45.18%,对照组视力显著要低于观察组,组间差异有统计学意义(P<0.05)。观察组出现35例,其中弥漫性渗透漏油20例,局限性+弥漫性渗漏13例,囊样水肿型渗漏2例,对照组患者仅出现12例囊样水肿型渗漏,观察组的局限性渗漏、弥漫性渗漏显著重于对照组,差异有统计学意义(P<0.05)。观察组患者术后的黄斑中心凹厚度显著厚于对照组,差异有统计学意义(P<0.05)。结论白内障术后,合并眼底病的糖尿病患者出现黄斑水肿的概率较高,其视力则是明显低于未合并糖尿病眼底病变者。因此,要在术前做好相应的预防措施,做好眼底病的检查与术后随访工作,以促进患者视力恢复和降低并发症发生概率。

Objective To clarify the preoperative macular edema and visual changes after cataract surgery.Methods In this study,70 patients with diabetes and fundus disease admitted in the hospital from May 2017 to June 2019 were selected as the observation group.All patients underwent cataract surgery,and 70 cases of cataract without diabetic fundus disease were selected as the control group.The postoperative macular edema and visual acuity of the patients were compared and analyzed.Results Before the operation,2 weeks,8 weeks and 6 months after the operation,the visual acuity of the observation group was<0.1,which accounted for 34.29%,respectively,and the visual acuity>0.1 accounted for 45.18%,respectively.The visual acuity of the control group was significantly lower than that of the observation group.The difference between them was statistically significant(P<0.05).There were 35 cases in the observation group,including 20 cases of diffuse osmotic oil leakage,13 cases of localized+diffuse leakage,2 cases of cystoid edema leakage,and only 12 cases of cystoid edema leakage occurred in the control group.Observation group of the localized leakage and diffuse leakage were significantly heavier than the control group,and the difference was statistically significant(P<0.05).The postoperative macular fovea thickness of the observation group was significantly thicker than that of the control group,the difference was statistically significant(P<0.05).Conclusion After cataract surgery,diabetic patients with fundus disease are more likely to have macular edema,and their vision is significantly lower than those without diabetic fundus disease.Therefore,it is necessary to take corresponding preventive measures before surgery,and do a good job in the examination of fundus disease and postoperative follow-up work to promote the recovery of patients'vision and reduce the chance of complications.