糖尿病患者白内障与老年性白内障超声乳化术前后房水蛋白浓度变化的比较

Comparison of aqueous protein concentrations after phacoemulsification in age-related cataract patients and cataract with diabetes mellitus

目的 通过检测老年性白内障与糖尿病患者白内障超声乳化白内障吸除并人工晶体植入手术前后房水蛋白浓度的变化 ,评估该手术对眼血 -房水屏障的影响。方法 对 60例 (64眼 )老年性白内障患者及 5 2例 (5 6眼 )伴发糖尿病的白内障患者 (3 4眼非增殖型糖尿病性视网膜病变 ,2 2眼伴增殖型糖尿病性视网膜病变 ) ,应用激光闪光细胞检测仪 (Laserflarecellmeter ,LFCM )定量检测超声乳化白内障吸除并人工晶体植入术前、术后前房蛋白浓度。结果 术前 ,伴增殖型糖尿病性视网膜病变患者的前房蛋白浓度高于老年性白内障和非增殖型糖尿病性视网膜病变白内障患者 ,且差异有显著性 (P <0 0 5 ) ;而老年性白内障和非增殖型糖尿病性视网膜病变白内障患者间的房水蛋白浓度无明显差别。各组术后 1天、 7天及 3 0天的房水蛋白浓度均较术前高 ,并有显著性差别 (P <0 0 5 )。术后 90天时 ,老年性白内障和非增殖型糖尿病性视网膜病变白内障患者的房水蛋白浓度与术前无显著性差别 ;但伴增殖型糖尿病性视网膜病变患者的仍高于术前水平 ,且差异有显著性 (P <0 0 5 )。结论 对于老年性白内障患者与非增殖型糖尿病性视网膜病变的白内障患者 ,超声乳化吸除并折叠式人工晶体植入手术后眼血 -房水屏障功能均可在短期内恢复 。

Objective To compare the function of the blood-aqueous barrier after phacoemulsification with implantation of foldable intraocular lens(IOL)in senile cataract patients and cataract patients with diabetes.Methods The blood-aqueous barrier function in 64 eyes of 60 senile cataract patients and 56 eyes of 52 cataract patients with diabetes who underwent phacoemulsification with intraocular lens implantation were examined using a laser flare cell meter.Quantitative measurements of anterior chamber aqueous protein concentration were performed preoperatively and on day 1,7,30 and day 90 after surgery.Results Before surgery,flare values in diabetic patients with proliferation diabetic retinopathy were significantly higher than in patients without diabetes mellitus and patients with non-proliferation diabetic retinopathy(P<0.05),and there was no significant difference between patients without diabetes mellitus and patients with non-proliferation diabetic retinopathy.Surgical trauma increased protein concentration on day 1,7 and 30 postoperatively in all patients.Recovery of protein concentration occurred on postoperative day 90 in patients without diabetes mellitus and patients with non-proliferation diabetic retinopathy.Conclusions For age-related cataract patients and diabetic cataract patients with non-proliferation diabetic retinopathy,the blood-aqueous barrier dysregulation had reestablished shortly after surgery,while a relative longer time was required for patients with proliferation diabetic retinopathy.