Pollack A, Dotan S, Oliver M
Ophthalmology Department, Kaplan Hospital, Rehovot, Israel.
Br J Ophthalmol. 1991 Jan;75(1):2-8. doi: 10.1136/bjo.75.1.2.
Five patients with mild to moderate retinopathy to both eyes underwent complication-free cataract surgery in one eye. Within three months of surgery deterioration of the retinopathy was observed in the operated eye only. In four patients there was an increase of intraretinal haemorrhages and hard exudates, accompanied by clinically significant macular oedema manifested as retinal thickening and extensive fluorescein leakage from both the macular and the peripapillary capillary networks. Of these four patients one also developed retinal ischaemia, evident ophthalmoscopically by flame-shaped haemorrhages and cotton-wool spots and angiographically by areas of capillary non-perfusion. The fifth patient showed proliferation of new blood vessels and vitreous haemorrhage. Diabetic patients scheduled for cataract surgery should undergo a thorough preoperative evaluation of any existing retinopathy. Postoperatively they should be followed up at close intervals so that any progression of retinopathy can be promptly detected and considered for laser treatment.
五名双眼患有轻度至中度视网膜病变的患者，一只眼睛接受了无并发症的白内障手术。术后三个月内，仅在手术眼观察到视网膜病变恶化。四名患者出现视网膜内出血和硬性渗出增加，伴有临床上显著的黄斑水肿，表现为视网膜增厚以及黄斑和视乳头周围毛细血管网广泛的荧光素渗漏。这四名患者中有一名还出现了视网膜缺血，眼底镜检查可见火焰状出血和棉絮斑，血管造影显示有毛细血管无灌注区。第五名患者出现了新生血管增殖和玻璃体积血。计划进行白内障手术的糖尿病患者应在术前对任何现有的视网膜病变进行全面评估。术后应密切随访，以便能及时发现视网膜病变的任何进展并考虑进行激光治疗。
