糖尿病眼底病变患者白内障术后黄斑水肿和视力情况

Analysis of macular edema and changes of visual acuity after cataract surgery in patients with DM fundus lesions

摘要:

目的：探讨糖尿病(DM)眼底病变患者白内障术后视力及黄斑水肿情况。

方法：选取2016-01/2017-09于我院治疗的白内障伴糖尿病眼底病变患者97例97眼，其中观察A组43例43眼(DM病程<5a)，观察B组54例54眼(DM病程≥5a)，同时选取单纯白内障患者60例60眼作为对照组，观察三组患者治疗前后最佳矫正视力(BCVA)、黄斑区视网膜厚度(中心凹区、内环区、外环区)、视网膜平均光敏感度(MS)等情况。

结果：术后1mo，对照组和观察A组患者BCVA优于观察B组(0.24±0.09)，差异均有统计学意义(P<0.05)； 观察B组患者黄斑区中心凹区、内环区和外环区厚度分别为283.30±17.06、335.51±20.26、297.28±20.22μm，均高于观察A组和对照组，差异均有统计学意义(P<0.05)； 观察B组患者MS(11.54±1.89dB)明显低于观察A组和对照组，差异均有统计学意义(P<0.05)。术后3mo，对照组总渗漏率明显低于观察A组和B组，观察B组总渗漏率(55.6%)明显高于观察A组，差异均有统计学意义(P<0.0167)。

结论：相比于单纯白内障患者，合并糖尿病眼底病变的患者术后视网膜厚度明显增加，易发生黄斑水肿，同时影响术后视力恢复，其中DM病程较长者尤其明显。

Abstract:

AIM: To investigate the condition of visual acuity and macular edema after cataract surgery in diabetes mellitus(DM)patients with fundus lesions.

METHODS: Totally 97 eyes of 97 patients with cataract and DM fundus lesion treated in our hospital from January 2016 to September 2017 were selected, and were divided into the observation group A, 43 cases 43 eyes(DM duration <5a), observation group B, 54 cases 54 eyes(DM duration ≥5a). Besides, 60 eyes of 60 patients with simple cataract were selected as the control group. The best corrected visual acuity(BCVA)and macular retinal thickness(foveal area, inner ring area, outer ring area), and the retinal mean sensitivity(MS)were observed before and after the treatment.

RESULTS: BCVA in control group and observation Group A was better than that in observation Group B(0.24±0.09)at 1mo after operation, and the difference was statistically significant(P<0.05). The thickness of fovea, inner ring and outer ring in Group B were 283.30±17.06μm, 335.51±20.26μm and 297.28±20.22μm, which were significantly higher than those in Group A and control group, and the difference was statistically significant(P<0.05). The MS in Group B(11.54±1.89dB)were obviously lower than the observation Group A and the control group, the difference was statistically significant(P<0.05). After 3mo, the total leakage rate of Group B(55.6%)was significantly higher than that of Group A and control group(P<0.0167).

CONCLUSION: Compared with simple cataract patients, the retinal thickness of patients with DM fundus disease is significantly increased, which is easy to has macular edema, and affects postoperative visual acuity recovery, in the patients with longer DM course which are especially obvious.