目的：研究2型糖尿病患者不同视网膜病变程度下眼表及角膜病变情况。

方法：纳入我院眼科就诊的2型糖尿病患者123例246眼，根据视网膜病变程度分为无糖尿病视网膜病变组46例92眼(non-diabetic retinopathy group，NDR)、非增殖性糖尿病视网膜病变组(non-proliferative diabetic retinopathy， NPDR)50例100眼和增殖性糖尿病视网膜病变组(proliferative diabetic retinopathy， PDR)27例54眼。通过干眼问卷和眼表疾病指数量表、角膜荧光素染色(FL)、基础泪液分泌试验(SⅠt)、泪膜破裂时间检测(BUT)及中央角膜厚度测量等临床检查，分析三组不同研究对象眼表不适症状、OSDI评分、FL阳性、SⅠt、角膜内皮细胞密度(CD)、BUT、角膜内皮细胞变异系数(CV)、中央角膜厚度(CCT)的差异。

结果：三组患者一般资料差异无统计学意义。眼痛、眼干涩、流泪、眼疲劳、烧灼感、视力波动等6项眼表不适症状在三组间比较差异具有统计学意义(均P<0.05)，异物感、眼痒、眼红差异无统计学意义(均P>0.05)； ODSI评分分级、FL阳性率、BUT、SⅠt、CD和CCT在三组间差异具有统计学意义(均P<0.05)； CV在三组间比较差异无统计学意义(P>0.05)。

结论：2型糖尿病患者具有明显的眼表不适症状； 泪膜稳定性下降、泪液分泌量减少、角膜内皮细胞密度下降； 角膜荧光素染色阳性率增加； 糖尿病患者中央角膜厚度增加，且这些变化均与糖尿病视网膜病变程度有关。

METHODS: A total of 123 patients(246 eyes)with T2DM were enrolled in this study. All of patients were divided into non-diabetic retinopathy group(46 patients 92 eyes), non-proliferative diabetic retinopathy group(50 patients 100 eyes)and proliferative diabetic retinopathy group(27 patients 54 eyes)according to the type of retinopathy. Dry eye questionnaire, ocular surface disease index(OSDI), Schirmer Ⅰ text(SⅠt), tear break-up time(BUT), fluorescein staining of cornea(FL), corneal endoscopy and central corneal thickness measurement were used to analyze the differences of three groups.

RESULTS: There was no statistically significant difference in general data between the three groups. Significant differences existed in eye pain, dry eyes, lacrimation, eye fatigue, burning sensation, vision fluctuations in three groups(P<0.05). Foreign body sensation, itchy eyes, red eyes showed no significant difference in groups(P>0.05). There were significant differences in ODSI value, FL positive rate, BUT, SIt, corneal endothelial cell density and central corneal thickness in three groups(P<0.05). variable coefficient of corneal endothelial cell showed no Significant difference in groups(P>0.05).

CONCLUSION: The findings of this study show that patients with type 2 diabetes mellitus presented obviously discomfort symptoms of ocular surface, decreased tear film stability, increased positive rate of corneal fluorescein staining; decreased density of corneal endothelial cells; increased central corneal thickness in diabetic patients, all of which were associated with degree of retinopathy.