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糖尿病患者白内障超声乳化术后糖尿病视网膜病变的进展:一项为期三年的分析。

Progression of diabetic retinopathy after phacoemulsification in diabetic patients: a three-year analysis.

作者信息

Liao Shuh-Bin, Ku Wan-Chen

机构信息

Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan, ROC.

出版信息

Chang Gung Med J. 2003 Nov;26(11):829-34.

Abstract

BACKGROUND

This retrospective study was conducted to analyze the progression rates of diabetic retinopathy (DR) after phacoemulsification in diabetic patients and to determine whether phacoemulsification causes the progression of DR.

METHODS

The medical charts of diabetic patients who had undergone cataract surgery using phacoemulsification techniques during a 3-year period and had completed 3 years of follow-up were retrospectively reviewed. Data were collected to evaluate the visual outcomes and progression of DR postoperatively. The retinopathy progression rates of operated and nonoperated eyes were compared.

RESULTS

Thirty-seven diabetic patients were enrolled. Binocular cataract surgeries were performed in 14 patients. Monocular cataract surgeries were performed in the remaining 23 patients whose nonoperated fellow eyes served as the control group. The postoperative retinopathy progression rates of eyes with preoperative mild to moderate nonproliferative diabetic retinopathy (NPDR) were significantly greater than eyes without preoperative retinopathy whether at postoperative 1 year or postoperative 3 years. No statistical significance was found for the rate of retinopathy progression between operated and nonoperated eyes at 1 year and 3 years postoperatively. Of 51 operated eyes, 33 (64.7%) achieved an uncorrected visual acuity of 20/40 at 1 year postoperatively, and 47 (92.1%) had improvement of visual acuity of more than two lines.

CONCLUSION

Uncomplicated phocoemulsificaton had no significant influence on the postoperative progression of DR. Patients with preoperative NPDR had greater chances to show postoperative retinopathy progression. The majority of diabetic patients who had no DR or had mild to moderate NPDR achieved visual improvement after phacoemulsification.

摘要

背景

本回顾性研究旨在分析糖尿病患者白内障超声乳化术后糖尿病视网膜病变(DR)的进展率,并确定超声乳化是否会导致DR进展。

方法

回顾性分析3年内接受白内障超声乳化手术并完成3年随访的糖尿病患者的病历。收集数据以评估术后视力结果和DR进展情况。比较手术眼和未手术眼的视网膜病变进展率。

结果

共纳入37例糖尿病患者。14例患者接受了双眼白内障手术。其余23例患者接受了单眼白内障手术,其未手术的对侧眼作为对照组。术前轻度至中度非增殖性糖尿病视网膜病变(NPDR)的患者术后1年和术后3年的视网膜病变进展率显著高于术前无视网膜病变的患者。术后1年和3年,手术眼和未手术眼的视网膜病变进展率无统计学差异。51只手术眼中,33只(64.7%)术后1年未矫正视力达到20/40,47只(92.1%)视力提高超过两行。

结论

单纯超声乳化对DR术后进展无显著影响。术前患有NPDR的患者术后视网膜病变进展的可能性更大。大多数无DR或患有轻度至中度NPDR的糖尿病患者在超声乳化术后视力得到改善。

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