超声乳化术对伴有糖尿病的白内障患者眼表及角膜内皮细胞的影响

Effect of phacoemulsification on ocular surface and corneal endothelial cells in cataract patients with diabetes mellitus

摘要:

目的：探究超声乳化术对伴有糖尿病的白内障患者眼表及角膜内皮细胞的影响。

方法：本研究为病历资料回顾性分析。选取2016-01/12于我校附属医院接受超声乳化术治疗的白内障患者98例98眼，根据是否合并糖尿病分为观察组和对照组。观察组为伴有糖尿病的白内障患者50例50眼，对照组为单纯白内障患者48例48眼。两组患者均行白内障超声乳化术，透明角膜切口，均由同一位医师完成，术前均无干眼症。术前糖尿病患者血糖控制正常，无眼底改变。观察两组患者术后1、3、7d，1mo的眼表情况。比较手术前后干眼症状评分、泪膜破裂时间(BUT)、角膜荧光素染色(FL)评分、泪液分泌试验(SchirmerⅠtest，SⅠt)结果以及角膜内皮细胞密度。

结果：两组手术前后干眼症状评分差异显著，术后7d，1mo观察组均显著高于对照组，差异均有统计学意义(P<0.05)，术后1、3d差异均无统计学意义(P>0.05)。两组手术前后BUT差异显著，术后7d，1mo观察组显著低于对照组，差异均有统计学意义(P<0.05)，术后1、3d差异均无统计学意义(P>0.05)。两组手术前后FL评分差异显著，术后3、7d，1mo观察组均显著高于对照组，差异均有统计学意义(P<0.05)，术后1d差异无统计学意义(P>0.05)。两组手术前后泪液分泌量差异显著，术后1、3、7d，1mo观察组均显著高于对照组，差异均有统计学意义(P<0.05)。两组手术前后角膜内皮细胞密度差异显著，术后1、3、7d，1mo观察组均显著低于对照组，差异均有统计学意义(P<0.05)。

结论：超声乳化术对伴有糖尿病的白内障患者泪膜破裂时间、泪液分泌量、干眼症症状等具有显著影响，可能与糖尿病患者对损伤的修复能力降低有关。

Abstract:

AIM:To study the effects of phacoemulsification on ocular surface and corneal endothelial cells in cataract patients with diabetes mellitus.

METHODS: This study used a retrospective analysis of the clinical data to compare curative effect, the research object was 98 cases(98 eyes)of cataract patients with phacoemulsification from January 2016 to December 2016 in our hospital. Patients were divided into the observation group and the control group according to whether diabetes merged. The observation group had 50 cases of cataract patients with diabetes, the control group had 48 cases of pure cataract patients. Two groups of patients underwent phacoemulsification surgery and transparent corneal incision, surgeries were completed by the same doctor, no xeroma before surgery. Preoperative glycemic control was normal for diabetic patients, no changes in eye fundus. Observation of ocular surface at postoperative 1, 3, 7d and 1mo was taken. Dry eye symptoms, lacrimal film breakup time(BUT), corneal fluorescein staining(FL)score, SchirmerⅠtest(SⅠt)and corneal endothelial cell density were compared.

RESULTS: Dry eye symptom score of the two groups before and after operation had significant difference; data of the observation group at postoperative 7d and 1mo was significantly higher than that of the control group, there was statistical significance(P<0.05), there was no significant difference at 1 and 3d after operation(P>0.05). BUT of the two groups before and after surgery showed significant difference; data of the observation group at 7d and 1mo after operation was significantly lower than that of the control group, there was statistical significance(P<0.05); at 1 and 3d after operation there was no significant difference(P>0.05). The FL score of the two groups before and after surgery had significant difference, and at 3,7d and 1mo after operation, data of the observation group was significantly higher than that of the control group, there was statistical significance(P<0.05); there was no significant difference at postoperative 1d(P>0.05). The two groups' before and after surgery SⅠt had significant difference, at 1, 3, 7d and 1mo after operation, data of the observation group was significantly higher than that of the control group, there was statistical significance(P<0.05). Corneal endothelial cell density showed apparent difference of the two groups before and after surgery; at 1, 3, 7d and 1mo after operation, data of the observation group was significantly lower than that of the control group, there was statistical significance(P<0.05).

CONCLUSION: Phacoemulsification has significant effects on tear film break-up time, SⅠt and dry eye symptoms in patients with diabetes mellitus, which may be related to the impaired repair ability of diabetic patients.