糖尿病性白内障患者超声乳化术后黄斑水肿的发病情况

Morbidity situation of macular edema in patients with diabetic cataract after phacoemulsification

目的分析糖尿病性白内障患者超声乳化术后黄斑水肿的发病情况。方法回顾性分析2013年1月~2015年1月山东省青州市眼科医院收治的白内障超声乳化及人工晶状体植入术患者113例(122眼)的临床资料,根据其有无糖尿病将其分为糖尿病组59例(64眼)、非糖尿病组54(58眼)。观察并比较治疗后两组患者黄斑水肿的发生情况、视力改善情况及黄斑中央凹区视网膜厚度。结果术后3个月,糖尿病组22眼发生黄斑水肿,发生率为48.44%;非糖尿病组5眼发生黄斑水肿,发生率为8.62%,糖尿病组黄斑水肿发生率明显高于非糖尿病组,差异有统计学意义(P<0.05),且眼底荧光血管造影检测显示,糖尿病组患者以局限性渗漏及弥漫性渗漏为主,非糖尿病组均为囊性水肿型渗漏,两组渗漏情况比较差异有统计学意义(P<0.05)。术后1个月,非糖尿病组患者最佳矫正视力明显优于糖尿病组,黄斑中央凹区视网膜厚度明显低于糖尿病组,差异均有统计学意义(P<0.05)。术前两组患者视力比较差异无统计学意义(P>0.05),术后两组患者视力均较术前得到明显改善(P<0.05),且术后1周、1个月、3个月糖尿病组视力均低于非糖尿病组,差异均有统计学意义(P<0.05)。结论糖尿病性白内障患者超声乳化术后黄斑水肿发生率明显高于非糖尿病性白内障患者,且术后视网膜厚度增加,明显影响视力的恢复。

Objective To analyze the morbidity situation of macular edema in patients with diabetic cataract after phacoemulsification. Methods The clinical data of 113 cases(122 eyes) of patients treated with cataract ultrasonic emulsification and intraocular lens implantation in Shandong Qingzhou Ophthalmic Hospital from January 2013 to January2015 was analyzed retrospectively, the patients were divided into diabetic group(59 cases, 64 eyes) and non-diabetic group(54 cases, 58 eyes) according to the presence of diabetes. Occurrence of macular edema, vision improved conditions, and macular retinal thickness of central sunken area of the two groups before and after treatment were observed and compared. Results Three months after surgery, there were 22 eyes of macular edema in the diabetic group, the incidence was 48.44%; there were 5 eyes of macular edema in the non-diabetic group, the incidence was 8.62%, the incidence of macular edema in the diabetes group was obviously higher than that of non-diabetic group, the difference was statistically significant(P < 0.05). Fluorescence fundus angiography examination showed that, diabetes patients showed mainly with leakage type of localized and diffuse leakage, the non-diabetic group was given priority to cystic oedema leakage, the leakage type between the two groups was statistically significant(P < 0.05). One month after surgery, the best corrected visual acuity of non-diabetic group was obviously better than that of diabetes group, and macular retinal thickness of central sunken area was lower than that of diabetes group, the differences were statistically significant(P < 0.05). Preoperative vision of the two groups had no statistically significant difference, postoperative visual acuity of two groups was improved significantly(P < 0.05), and 1 week, 1 month, and 3 months after surgery, vision of patients in diabetes group was all lower than those of non-diabetic group, the differences were statistically significant(P < 0.05). Conclusion The incidence of diabetic cataract patients with macular edema after phacoemulsification is significantly higher than that of non-diabetic cataract patients, and postoperative retinal thickness is increased,which significantly affects the recovery of vision.