白内障合并2型糖尿病患者超声乳化术后黄斑区厚度及眼表的变化
Changes of macular thickness and ocular surface in type 2 diabetes mellitus patients with concomitnat cataract after phacoemulsification
崔兵杰 1邹媛媛1
作者信息
- 1. 沧州市中心医院眼科,沧州 061000
- 折叠
摘要
目的 分析合并2型糖尿病的白内障患者超声乳化术后黄斑区厚度及眼表的变化.方法 前瞻性非随机对照研究.选取沧州市中心医院2022年1月至2023年3月合并有2型糖尿病的白内障患者50例(50眼),设为观察组.选择同期非糖尿病单纯白内障患者50例(50眼)纳入对照组,均行超声乳化人工晶状体植入术,比较两组患者手术前后黄斑中心区厚度(CMT)、眼表疾病指数(OSDI)评分、泪膜破裂时间(BUT)及泪液分泌试验(S Ⅰ t)的变化.根据观察组术前糖化血红蛋白(HbA1c)水平分为高HbA1c组和低HbA1c组,比较两组患者手术后CMT变化.结果 两组患者术前CMT、OSDI评分、BUT及S Ⅰ t比较差异均无统计学意义(均P＞0.05).在术后4周及12周,观察组患者CMT高于对照组,差异有统计学意义(t=3.70、3.79,均P＜0.001).观察组患者OSDI评分在术后1周及4周高于对照组,差异有统计学意义(t=5.19、3.02,P＜0.001、P=0.003).术后1周及4周,观察组患者S I t低于对照组,差异有统计学意义(t=-2.71、-2.47,P=0.008、0.015).观察组患者的BUT在术后1周及4周低于对照组,差异有统计学意义(t=-3.69、-3.43,P＜0.001、P=0.001).术后各时间点高HbA1c组的CMT高于低HbA1c组,差异有统计学意义(t=2.53、2.41、2.44、2.52,P=0.015、0.020、0.019、0.015).结论 合并 2型糖尿病的白内障患者相比非糖尿病患者,对手术耐受性低,术后其泪膜稳定性及泪液分泌下降,CMT明显增加,并且HbA1c水平越高,术后CMT增加越明显.
Abstract
Objective To analyze the changes of macular thickness and ocular surface in type 2 diabetes mellitus patients with concomitant cataract after phacoemulsification.Methods This was a prospective randomized controlled study.Fifty eyes of 50 cataract patients with type 2 diabetes mellitus who were admitted to Cangzhou Municipal Central Hospital from Jan.2022 to Mar.2023 were selected as the observation group.The control group was selected from 50 non-diabetic patients with simple cataract during the same period,all of whom underwent phacoemulsification combined with intraocular lens implantation.The changes of central macular thickness(CMT),ocular surface disease index(OSDI)score,break-up time(BUT)and Schirmer Ⅰ test(S Ⅰ t)before and after surgery were compared between the two groups.The observation group was divided into the high glycosylated hemoglobin(HbA1c)group and the low HbA1c group according to preoperative HbA1c level.CMT changes before and after operation were compared between the two groups.Results There were no differences in preoperative CMT,OSDI scores,BUT and S Ⅰ t between the two groups(all P＞0.05).CMT in the observation group was higher than that in the control group at 4 and 12 weeks after surgery,and the difference was statistically significant(t=3.70,3.79;all P＜0.001).OSDI scores in the observation group were higher than those in the control group at 1 and 4 weeks after surgery,and the difference was statistically significant(t=5.19,3.02;P＜0.001,P=0.003).sIt in the observation group was lower than that in the control group at 1 and 4 weeks after surgery,and the difference was statistically significant(t=-2.71,-2.47;P=0.008,0.015).The BUT in the observation group was lower than that in control group at 1 and 4 weeks after surgery,and the difference was statistically significant(t=-3.69,-3.43;P＜0.001,P=0.001).The CMT of the high HbA1c group was higher than that of the low HbA1c group at all time points after surgery,and the difference was statistically significant(t=2.53,2.41,2.44,2.52;P=0.015,0.020,0.019,0.015).Conclusion Compared with non-diabetic cataract patients,cataract patients with diabetes mellitus have lower tolerance to surgery.After surgery,the stability of tear film and the basal tear secretion decrease while the thickness of macular fovea increases significantly.And the higher the HbA1c level,the more significant the increase in postoperative CMT.
关键词
超声乳化术/糖尿病,2型/白内障Key words
Phacoemulsification/Diabetes mellitus,type 2/Cataract引用本文复制引用
基金项目
沧州市重点研发计划指导项目(213106055)
出版年
2024
NETL
NSTL
万方数据