糖尿病性白内障超声乳化术后角膜的变化

目的 评价超声乳化白内障吸除术对糖尿病性白内障术后角膜内皮及厚度等指标的影响.方法 96例(96眼)2型糖尿病性白内障患者(糖尿病组)以及252例(252眼)老年性白内障患者(老年组)接受超声乳化白内障吸出联合后房型人工晶状体植入术,比较两组患者术前及术后1周、4周、8周泪膜破裂时间、基础泪液分泌、角膜内皮细胞密度以及中央角膜厚度.结果 术后1周、4周、8周糖尿病组患者的泪膜破裂时间、基础泪液分泌、角膜内皮细胞密度以及中央角膜厚度与术前差异均有统计学意义(均为P＜0.05);老年组患者的角膜内皮细胞密度差异均有统计学意义(均为P＜0.05),而泪膜破裂时间、基础泪液分泌以及中央角膜厚度差异均无统计学意义(均为P＞0.05).与老年组相比,糖尿病组患者术前及术后1周、4周、8周泪膜破裂时间、基础泪液分泌、角膜内皮细胞密度以及中央角膜厚度差异均有统计学意义(均为P＜0.05).结论 糖尿病患者泪膜稳定性、基础泪液分泌以及角膜内皮细胞密度均显著降低,白内障超声乳化吸出术后这些眼部体征更加显著,术中及术后加强保护角膜内皮及眼表面组织,控制术后组织反应是减少糖尿病性白内障术后并发症的重要手段.

Changes in cornea after phacoemulsification in diabetic patients

Objective To evaluate the effect of phacoemulsification on the corneal endothelium and thickness of diabetic cataract patients.Methods Cataract surgery of phacoemulsification with intraocular lens implantation was performed on together 348 eyes of 348 patients,including 96 eyes of 96 patients suffered from type 2 diabetes (diabetic group) and 252 eyes of 252 patients suffered from senile cataract (elderly group).Then,tear break-up time,basal tear secretion,corneal endothelial density and central corneal thickness were detected before surgery and 1 week,4 weeks and 8 weeks after surgery.Results There were significant difference in tear break-up time,basal tear secretion,corneal endothelial density and central corneal thickness before surgery and 1 week,4 weeks and 8 weeks after surgery between the two groups (all P ＜0.05).There were significant difference in corneal endothelial density (all P ＜ 0.05),but there was no significant difference in tear break-up time,basal tear secretion and central corneal thickness before and after surgery in the elderly group (all P ＞ 0.05).Intergroup comparison of tear break-up time,basal tear secretion,corneal endothelial density and central corneal thickness were significantly different before and after operation (all P ＜ 0.05).Conclusion Cataract surgery of phacoemulsification can achieve satisfying outcomes and it is crucial to protect the corneal endothelium and ocular surfacetissue intraoperatively and postoperatively for the patient with diabetic cataract.