中华眼科医学杂志(电子版)
中華眼科醫學雜誌(電子版)
중화안과의학잡지(전자판)
CHINESE JOURNAL OF OPHTHALMOLOGIC MEDICINE(ELECTRONIC EDITION)
2014年
6期
326-329
,共4页
黄斑囊样水肿%糖尿病性视网膜病变%视力%白内障%手术
黃斑囊樣水腫%糖尿病性視網膜病變%視力%白內障%手術
황반낭양수종%당뇨병성시망막병변%시력%백내장%수술
Macular edema%Diabetic retinal pathological changes%Vision%Cataract%Surgery
目的:探讨合并糖尿病性视网膜病变患者白内障术后视功能的改变情况。方法收集山东省泰山医学院附属肥城市人民医院眼科2013年1月至2014年2月期间收治的88例(88只眼)白内障患者的临床资料,按照眼底病变程度将其中48例(48只眼)伴有轻度至中度糖尿病眼底改变的患者作为糖尿病组;将40例(40只眼)眼底正常的患者作为对照组。两组患者的手术方式、术后处理方法及手术操作人员均相同。糖尿病组和对照组患者术后进行荧光素眼底血管造影( FFA)检查,其检查结果发现的囊样水肿型渗漏、局限性渗漏、弥漫性渗漏、局限性合并弥漫性渗漏、无渗漏等各分型用眼数和百分比的形式表示,并采用χ2检验的方法进行比较;两组患者手术后的最佳矫正视力按照<0.1、0.1~0.4、0.5~0.9、≥1.0分为4个等级,采用眼数和百分比的形式表示,并采用Kruskal-Wallis H秩和检查的方法进行比较。结果糖尿病组48例(48只眼)患者中,术后发生囊样水肿型渗漏者15例(15只眼),占31.25%;发生局限性渗漏者3例(3只眼),占29.27%;发生弥漫性渗漏者6例(6只眼),占2.44%;发生局限性合并弥漫性渗漏者4例(4只眼),占8.30%,无渗漏者20例(20只眼),占41.70%。对照组40例(40只眼)患者中,发生囊样水肿型渗漏者5例(5只眼),占12.50%;无渗漏发生者35例(35只眼),占87.50%。两组患者术后FFA检查情况比较,差异有统计学意义(χ2=21.54,P<0.05)。糖尿病组48例(48只眼)患者中,视力<0.1者2例(2只眼),占4.17%;视力为0.1~0.4者11例(11只眼),占22.91%;视力为0.5~0.9者30例(30只眼),占62.50%;视力≥1.0者5例(5只眼),占10.42%。对照组40例(40只眼)患者中,视力<0.1者0例(0只眼),占0.00%;视力为0.1~0.4者7例(7只眼),占17.50%;视力为0.5~0.9者25例(25只眼),占62.50%;视力≥1.0者8例(8只眼),占20.00%。两组患者术后的最佳矫正视力比较,差异无统计学意义(Hc=-0.19,P>0.05)。结论白内障摘除术后无论对于伴有轻、中度糖尿病患眼底病变患者,还是对于正常眼底患者,均有可能引起临床型黄斑囊样水肿( CME)。但是二者在视力恢复上差异无统计学意义,且出现临床型CME时予以随诊,通常不需要处理,大部分可自行恢复。
目的:探討閤併糖尿病性視網膜病變患者白內障術後視功能的改變情況。方法收集山東省泰山醫學院附屬肥城市人民醫院眼科2013年1月至2014年2月期間收治的88例(88隻眼)白內障患者的臨床資料,按照眼底病變程度將其中48例(48隻眼)伴有輕度至中度糖尿病眼底改變的患者作為糖尿病組;將40例(40隻眼)眼底正常的患者作為對照組。兩組患者的手術方式、術後處理方法及手術操作人員均相同。糖尿病組和對照組患者術後進行熒光素眼底血管造影( FFA)檢查,其檢查結果髮現的囊樣水腫型滲漏、跼限性滲漏、瀰漫性滲漏、跼限性閤併瀰漫性滲漏、無滲漏等各分型用眼數和百分比的形式錶示,併採用χ2檢驗的方法進行比較;兩組患者手術後的最佳矯正視力按照<0.1、0.1~0.4、0.5~0.9、≥1.0分為4箇等級,採用眼數和百分比的形式錶示,併採用Kruskal-Wallis H秩和檢查的方法進行比較。結果糖尿病組48例(48隻眼)患者中,術後髮生囊樣水腫型滲漏者15例(15隻眼),佔31.25%;髮生跼限性滲漏者3例(3隻眼),佔29.27%;髮生瀰漫性滲漏者6例(6隻眼),佔2.44%;髮生跼限性閤併瀰漫性滲漏者4例(4隻眼),佔8.30%,無滲漏者20例(20隻眼),佔41.70%。對照組40例(40隻眼)患者中,髮生囊樣水腫型滲漏者5例(5隻眼),佔12.50%;無滲漏髮生者35例(35隻眼),佔87.50%。兩組患者術後FFA檢查情況比較,差異有統計學意義(χ2=21.54,P<0.05)。糖尿病組48例(48隻眼)患者中,視力<0.1者2例(2隻眼),佔4.17%;視力為0.1~0.4者11例(11隻眼),佔22.91%;視力為0.5~0.9者30例(30隻眼),佔62.50%;視力≥1.0者5例(5隻眼),佔10.42%。對照組40例(40隻眼)患者中,視力<0.1者0例(0隻眼),佔0.00%;視力為0.1~0.4者7例(7隻眼),佔17.50%;視力為0.5~0.9者25例(25隻眼),佔62.50%;視力≥1.0者8例(8隻眼),佔20.00%。兩組患者術後的最佳矯正視力比較,差異無統計學意義(Hc=-0.19,P>0.05)。結論白內障摘除術後無論對于伴有輕、中度糖尿病患眼底病變患者,還是對于正常眼底患者,均有可能引起臨床型黃斑囊樣水腫( CME)。但是二者在視力恢複上差異無統計學意義,且齣現臨床型CME時予以隨診,通常不需要處理,大部分可自行恢複。
목적:탐토합병당뇨병성시망막병변환자백내장술후시공능적개변정황。방법수집산동성태산의학원부속비성시인민의원안과2013년1월지2014년2월기간수치적88례(88지안)백내장환자적림상자료,안조안저병변정도장기중48례(48지안)반유경도지중도당뇨병안저개변적환자작위당뇨병조;장40례(40지안)안저정상적환자작위대조조。량조환자적수술방식、술후처리방법급수술조작인원균상동。당뇨병조화대조조환자술후진행형광소안저혈관조영( FFA)검사,기검사결과발현적낭양수종형삼루、국한성삼루、미만성삼루、국한성합병미만성삼루、무삼루등각분형용안수화백분비적형식표시,병채용χ2검험적방법진행비교;량조환자수술후적최가교정시력안조<0.1、0.1~0.4、0.5~0.9、≥1.0분위4개등급,채용안수화백분비적형식표시,병채용Kruskal-Wallis H질화검사적방법진행비교。결과당뇨병조48례(48지안)환자중,술후발생낭양수종형삼루자15례(15지안),점31.25%;발생국한성삼루자3례(3지안),점29.27%;발생미만성삼루자6례(6지안),점2.44%;발생국한성합병미만성삼루자4례(4지안),점8.30%,무삼루자20례(20지안),점41.70%。대조조40례(40지안)환자중,발생낭양수종형삼루자5례(5지안),점12.50%;무삼루발생자35례(35지안),점87.50%。량조환자술후FFA검사정황비교,차이유통계학의의(χ2=21.54,P<0.05)。당뇨병조48례(48지안)환자중,시력<0.1자2례(2지안),점4.17%;시력위0.1~0.4자11례(11지안),점22.91%;시력위0.5~0.9자30례(30지안),점62.50%;시력≥1.0자5례(5지안),점10.42%。대조조40례(40지안)환자중,시력<0.1자0례(0지안),점0.00%;시력위0.1~0.4자7례(7지안),점17.50%;시력위0.5~0.9자25례(25지안),점62.50%;시력≥1.0자8례(8지안),점20.00%。량조환자술후적최가교정시력비교,차이무통계학의의(Hc=-0.19,P>0.05)。결론백내장적제술후무론대우반유경、중도당뇨병환안저병변환자,환시대우정상안저환자,균유가능인기림상형황반낭양수종( CME)。단시이자재시력회복상차이무통계학의의,차출현림상형CME시여이수진,통상불수요처리,대부분가자행회복。
Objective To assess changes in visual acuity in patients with macular edema and fundus lesions after cataract surgery.Methods A total of cataract 88 patients (88 eyes) who were seeking care in the Department of Ophthalmology, Taishan Medical College-Affiliated Feicheng People ’ s Hospital between January,2013 and February,2014 were recruited.They were classified as cataract with mild to moderate diabetic fundus lesions (n=48) and as conventional cataract without diabetic fundus lesions (n=40) .Extracapsular cataract extraction with posterior chamber intraocular lens implantation was performed by a single surgeon on all patients.Macular edema was assessed by fundus fluorescein angiography ( FFA) and best-corrected visual acuity (BCVA) was measured and graded as <0.01,0.01-0.5,0.1-1.0,and >1.0. Data on these two variables were analyzed byχ2 test and Kruskal Wallis H-rank test respectively.Results In the diabetic fundus lesion group,pouch edema leakage was observed 15(31.25%) cases,localized leakage in 3(29.27%) cases,diffuse leakage in 6(2.44%) cases, localized and diffuse leakage in 4(8.30%) cases, and no leakage in 20 (41.70%) cases.In the non-diabetic fundus lesion group, pouch oedema leakage occurred in 5(12.50%) cases and no leakage in 35(87.50%) cases.The difference in edema leakage was statistically significant between two groups of patients (χ2=21.54,P<0.05).In the diabetic fundus lesion group,postoperative BCVA was <0.1 in 2 (4.17%) eyes,0.1-0.5 in 11(22.91%) eyes,0.5-1.0 in 30 (62.50%) eyes,and >1.0 in 5 (10.42%) eyes.In the non-diabetic fundus lesion group, postoperative BCVA was 0.1-0.4 in 7(17.50%) eyes,0.5-0.9 in 25(62.50%) eyes, >1.0 in 8(20.0%) eyes.The two groups of patients significantly differed in postoperative BCVA ( Hc =0.19, P >0.05 ). Conclusion Cataract patients without diabetic fundus lesions have significantly better BCVA and significantly lower risk of macular edema development following extracapsular cataract extraction with posterior chamber intraocular lens implantation as compared with cataract patients with diabetic fundus lesions.