糖尿病患者白内障超声乳化吸出联合人工晶状体植入

目的　观察糖尿病患者行白内障超声乳化吸出联合人工晶状体植入术的临床效果。方法　对884 例1 079 眼患有糖尿病的白内障术后患者的视力及并发症进行分析,并选取同时期、同一手术医师施行的非糖尿病白内障患者做对照。手术采用巩膜隧道切口超声乳化及囊袋内人工晶状体植入法。术前空腹血糖控制在8.5 mmol·L-1以下。结果　糖尿病患者术后3 d矫正视力与非糖尿病患者相比无明显差异(P>0 05),<0.5者454眼,均为眼底出血、渗出累及黄斑及黄斑囊样水肿、增殖性视网膜病变所致。糖尿病患者术前瞳孔不能充分散大或术中瞳孔缩小、瞳孔缘损伤和术后角膜水肿、黄斑水肿的病例明显多于非糖尿病患者。结论　糖尿病患者行白内障超声乳化吸出联合人工晶状体植入术,可明显改善视力,超声乳化吸出术治疗糖尿病患者白内障是安全有效的,并为糖尿病视网膜病变的荧光血管造影和激光治疗提供了条件。眼底出血、渗出累及黄斑、黄斑囊样水肿、增殖性糖尿病视网膜病变是影响术后视力的主要因素。

Phacoemulsification combined with intraocular lens implantation on diabetic patients

Objective To analyze the clinical effect of phacoemulsification combined with intraocular lens implantation in the cataract patients with diabetic.Methods Eight hundred and eighty-four cases(1 079 eyes)of post-operative patients'vision and complications were analyzed.The cataract patients without diabetics with the same age and the same sex who were operated by the same surgeon in the same duration were designed in control group.Phacoemulsification were performed through sclera tunnel and intraocular lens implantations were taken on all these patients.Results Three days after surgery,there was no significant difference in post-operative vision between diabetics group and no diabetics group.Four hundred and fifty-four eyes have best corrected visual acuity <0.5 in diabetics group caused by fundus hemorrhage,exudation involving macula,cystoid macular edema,proliferated diabetic retinal disease.The diabetics group has obvious more complications such as pupil dilate not enough before operation,pupil contraction and iris bite during operating and corneal edema and cystoid macular edema after operation.Conclusion The visual acuity can be raised obviously after the phacoemulsification combined with intraocular lens implantation in diabetic patients.The operation is safe and it also supplies the fluorescence angiography and laser treatment of diabetic retinal disease.The complications mainly affecting the visual acuity after surgery include fundus hemorrhage,exudation involving macula,cystoid macular edema,proliferated diabetic retinal disease.