CAJ | 학술논문

目的通过比较糖尿病患者与非糖尿病患者白内障术后发生黄斑水肿(ME)的差异,探讨差异产生的原因.方法前瞻性研究.选取2011年4月至2013年5月于北京大学眼科中心行白内障超声乳化+人工晶状体植入术患者112例175只眼,其中糖尿病患者72只眼,非糖尿病患者103只眼.主要检测指标是两组术前、术后1月及术后3月的最佳矫正视力(BCVA)及黄斑中心亚区域平均厚度(CSMT).结果非糖尿病组术前、术后1月及术后3月BCVA均明显好于糖尿病组,差异有统计学意义(t =-2.237,P=0.027;t=-2.504,P=0.013;t=-2.233,P=0.027).非糖尿病组术前、术后1月及术后3月CSMT均明显低于糖尿病组,差异有统计学意义(t=-2.200,P=0.029;t =-3.906,P=0.000;t=-3.399,P=0.001).术后1月非糖尿病组发生黄斑水肿为1只眼(0.97％1/103),糖尿病组黄斑水肿为9只眼(12.5％ 9/72),差异有统计学意义(x2=10.455,P=0.001);术后3月非糖尿病组发生黄斑水肿为1只眼(0.97％1/103),糖尿病组黄斑水肿为6只眼(8.33％ 6/72),差异有统计学意义(x2=5.982,P=0.014).黄斑水肿与糖尿病视网膜病变严重程度相关(P =0.015).结论糖尿病患者行白内障超声乳化术后黄斑水肿的发生率高,糖尿病视网膜病变的严重程度是主要影响因素.
목적 통과비교당뇨병환자여비당뇨병환자백내장술후발생황반수종(ME)적차이,탐토차이산생적원인.방법 전첨성연구.선취2011년4월지2013년5월우북경대학안과중심행백내장초성유화+인공정상체식입술환자112례175지안,기중당뇨병환자72지안,비당뇨병환자103지안.주요검측지표시량조술전、술후1월급술후3월적최가교정시력(BCVA)급황반중심아구역평균후도(CSMT).결과 비당뇨병조술전、술후1월급술후3월BCVA균명현호우당뇨병조,차이유통계학의의(t =-2.237,P=0.027;t=-2.504,P=0.013;t=-2.233,P=0.027).비당뇨병조술전、술후1월급술후3월CSMT균명현저우당뇨병조,차이유통계학의의(t=-2.200,P=0.029;t =-3.906,P=0.000;t=-3.399,P=0.001).술후1월비당뇨병조발생황반수종위1지안(0.97％1/103),당뇨병조황반수종위9지안(12.5％ 9/72),차이유통계학의의(x2=10.455,P=0.001);술후3월비당뇨병조발생황반수종위1지안(0.97％1/103),당뇨병조황반수종위6지안(8.33％ 6/72),차이유통계학의의(x2=5.982,P=0.014).황반수종여당뇨병시망막병변엄중정도상관(P =0.015).결론당뇨병환자행백내장초성유화술후황반수종적발생솔고,당뇨병시망막병변적엄중정도시주요영향인소.
Objective To analyze the reasons for different incidence of macular edema (ME) after cataract surgery in diabetic and non-diabetic patients using optical coherence tomography (OCT).Methods In a prospective clinical study,175 eyes of 112 cataract patients were enrolled in the study.The study included 72 eyes from diabetic patients and 103 eyes from non-diabetic subjects.All patients underwent uncomplicated cataract surgery with phacoemulsification.Main outcome measures included best-corrected visual acuity (BCVA) and central subfield mean thickness (CSMT).CSMT was examined using OCT within 4 weeks preoperatively and 1 month and 3 months postoperatively.Macular edema was defined as an increase of CSMT (Δ CSMT) on OCT ＞30％ from baseline.Results There were significantly differences in BCVA and CSMT between diabetic and non-diabetic subjects preoperatively,1 month and 3 months after cataract surgery.One month after surgery,incidence of ME of diabetic subjects (12.50％)(9/72) was significantly more (x2=10.455,P =0.001) than of non-diabetic subjects (0.97％)(1/103).Three months after surgery,incidence of ME of diabetic subjects (8.33％)(6/72) was significantly more (x2=5.982,P =0.014) than of non-diabetic subjects (0.97％)(1/103).The degree of diabetic retinopathy might be correlated to macular edema after surgery.Conclusions There is a higher incidence of ME in diabetic patients.The degree of diabetic retinopathy might be correlated to macular edema after surgery.