Sadiq S A, Sleep T, Amoaku W M
Department of Ophthalmology, Queen's Medical Centre, Nottingham, U.K.
Eur J Ophthalmol. 1999 Jan-Mar;9(1):14-20. doi: 10.1177/112067219900900103.
A study was designed to investigate the visual improvement and incidence of progression of retinopathy in diabetic patients following extracapsular cataract extraction or phacoemulsification. They were compared to a matched group of non-diabetic patients.
A retrospective analysis of all diabetic patients (118) undergoing ECCE (90) or phacoemulsification (28) in 1995. These patients were operation and age matched with 118 non-diabetic patients who underwent surgery during the same year.
There was no statistically significant difference in complications following ECCE in diabetic and non-diabetic patients (p = 0.2). Complications were however more common in non-diabetic patients undergoing phacoemulsification compared to diabetics undergoing the same procedure (p = 0.046). Although consultants performed 42% of the surgery in diabetics compared to 31% in non-diabetics, there was no significant difference in the rate of complications between consultants and residents (p = 0.8). Overall the visual improvement in non-diabetics was better than diabetic patients (p = 0.006). This was due to a better improvement amongst non-diabetic patients undergoing phacoemulsification (p = 0.02). Overall, cataract surgery was found to lead to a worsening in retinopathy in 19 operated eyes (15 had no retinopathy preoperatively) compared to a worsening in 8 fellow eyes. This was statistically significant (p = 0.04). However, ECCE was no more likely to cause worsening of retinopathy than phacoemulsification (p = 0.87).
Diabetic patients due to undergo cataract surgery a) have a good chance of visual improvement but to a level less than if they were not diabetic, b) have a greater chance of visual loss, c) surgery may initiate or worsen any pre-existing retinopathy and this may affect their vision in the future.
一项研究旨在调查糖尿病患者在囊外白内障摘除术或超声乳化白内障吸除术后视网膜病变的视力改善情况及进展发生率。将他们与一组匹配的非糖尿病患者进行比较。
对1995年接受囊外白内障摘除术（90例）或超声乳化白内障吸除术（28例）的所有糖尿病患者进行回顾性分析。这些患者在手术和年龄方面与同年接受手术的118例非糖尿病患者相匹配。
糖尿病患者和非糖尿病患者在囊外白内障摘除术后的并发症方面无统计学显著差异（p = 0.2）。然而，与接受相同手术的糖尿病患者相比，接受超声乳化白内障吸除术的非糖尿病患者并发症更常见（p = 0.046）。尽管在糖尿病患者中，顾问医生实施了42%的手术，而非糖尿病患者中这一比例为31%，但顾问医生和住院医生的并发症发生率无显著差异（p = 0.8）。总体而言，非糖尿病患者的视力改善优于糖尿病患者（p = 0.006）。这是由于接受超声乳化白内障吸除术的非糖尿病患者视力改善更好（p = 0.02）。总体而言，发现白内障手术导致19只手术眼的视网膜病变恶化（15只术前无视网膜病变），而8只对侧眼恶化。这具有统计学显著性（p = 0.04）。然而，囊外白内障摘除术导致视网膜病变恶化的可能性并不比超声乳化白内障吸除术更高（p = 0.87）。
即将接受白内障手术的糖尿病患者：a）视力有改善机会，但改善程度低于非糖尿病患者；b）视力丧失的可能性更大；c）手术可能引发或加重任何已存在的视网膜病变，这可能会影响他们未来的视力。
