Abstract:AIM: To observe the clinical outcome of Phacoemulsification(Phaco)and IOL implantation on cataract patients with diabetes mellitus(DM)and analyze factors influencing visual acuity after Phaco.
METHODS:Phacoemulsification and IOL implantation were applied to 40 cataract patients(62 eyes)with type II DM(research group)and 60 cataract patients(82 eyes, control group)between January 2010 and December 2010. Visual acuity was measured 1 day, 1 week, 1 month, 3 months and 6 months post-operation. Central corneal thickness and endothelial cells count were examined pre-operation and 1 day, 1 week, 1 month, 3 months and 6 months post-operation. Fundus was examined under pupil dilatation 3 months and 6 months post-operation. In research group, 41 eyes were observed with non-diabetic retinopathy(NDR)and 21 eyes with DR.
RESULTS: Best corrected visual acuity(BCVA): 1 day, 1 week and 1 month post-operation, significant difference was observed between research group and control group(P<0.05). No significant difference was observed 3 months post-operation between NDR group and control group(P>0.05). Significant difference was observed between NDR and DR as well as between DR and control(P<0.05). No significant difference was observed 6 months post-operation between NDR and DR as well as between NDR and control(P>0.05). Significant difference was observed between DR and control(P<0.05). Central corneal thickness: significant differences were observed between 2 groups 1 day, 1 week, 1 month and 3 months post-operation(P<0.05). No significant differences were observed between 2 groups 6 months post-operation(P>0.05). When measured 1 day, 1 week post-operation, both groups have significant differences compared to pre-operation result(P<0.05). One month and 3 month post-operation, significant difference was observed in research group compared to pre-operation data(P<0.05), while there was no significant difference for control group(P>0.05). Six months post-operation, there was no significant difference compared to pre-operation result between 2 groups(P>0.05). Corneal endothelial cells count: No significant difference was observed between 2 groups pre-operation(P>0.05). Significant differences were observed between 2 groups when measured 1 day, 1 week, 1 month, 3 months and 6 months post-operation(P<0.05). Both groups showed significant difference in 1 week, 1 month, 3 months and 6 months compared to pre-operation measurement(P<0.05).
CONCLUSION: For DM patients after Phaco, key incipient influencing factor of VA is transient cornea edema, while chief factor influencing VA in mid-term is concomitant DR. More severe endothelial damage and recovery retardation of corneal edema were observed in cataract patients with DM after Phaco.
