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白内障手术后糖尿病视网膜病变黄斑厚度变化的评估

Evaluation of changes of macular thickness in diabetic retinopathy after cataract surgery.

作者信息

Kwon Soon Il, Hwang Duck Jin, Seo Ji Young, Park In Won

机构信息

Department of Ophthalmology, Hallym University Sacred Heart Hospital, #896 Pyeongchon-dong, Anyang, Korea.

出版信息

Korean J Ophthalmol. 2011 Aug;25(4):238-42. doi: 10.3341/kjo.2011.25.4.238. Epub 2011 Jul 22.

Abstract

PURPOSE

To assess the macular thickness changes after cataract surgery in diabetic patients using optical coherence tomography (OCT).

METHODS

We retrospectively reviewed the records of 104 diabetic patients who underwent cataract surgery. We examined the changes of macular thickness using OCT before cataract surgery and 1 week, 1-, 2- and 6-months after surgery. The central subfield mean thickness (CSMT) was used to evaluate macular edema which was defined as an increase of CSMT (ΔCSMT) > 30% from the baseline. The association between prior laser treatment or severity of diabetic retinopathy and macular thickness were also analyzed.

RESULTS

Macular edema occurred in 19 eyes (18%) from the diabetic group and 63% of macular edema developed at 1 month after surgery. Thirteen (68%) out of 19 eyes with macular edema showed the resolution of macular edema by 6 months after surgery without treatment. ΔCSMT of eyes without a history of laser treatment was statistically greater compared to eyes with a history of laser treatment in at 1- and 2-months after surgery, but was not different than eyes who had laser treatment at 6-months after surgery. The severity of diabetic retinopathy was not significantly correlated to macular edema, but there was statistical difference when patients who had a history of prior laser treatment were excluded.

CONCLUSIONS

The incidence of macular edema after cataract surgery in diabetic patients was 18%. Its peak incidence was at 1 month post surgery and it resolved spontaneously in 68% of patients by 6 months post surgery. Prior laser treatment might prevent postoperative macular edema until 2 months after cataract surgery in diabetic patients. However, macular edema did not affect the severity of diabetic retinopathy.

摘要

目的

使用光学相干断层扫描(OCT)评估糖尿病患者白内障手术后黄斑厚度的变化。

方法

我们回顾性分析了104例接受白内障手术的糖尿病患者的病历。我们在白内障手术前以及手术后1周、1个月、2个月和6个月使用OCT检查黄斑厚度的变化。中心子区域平均厚度(CSMT)用于评估黄斑水肿,其定义为CSMT较基线增加(ΔCSMT)>30%。我们还分析了既往激光治疗或糖尿病视网膜病变严重程度与黄斑厚度之间的关联。

结果

糖尿病组19只眼(18%)发生黄斑水肿,其中63%的黄斑水肿在术后1个月出现。19只发生黄斑水肿的眼中,13只(68%)在术后6个月未经治疗黄斑水肿消退。术后1个月和2个月时,无激光治疗史的眼的ΔCSMT在统计学上高于有激光治疗史的眼,但术后6个月时与接受过激光治疗的眼无差异。糖尿病视网膜病变的严重程度与黄斑水肿无显著相关性,但排除有既往激光治疗史的患者后存在统计学差异。

结论

糖尿病患者白内障手术后黄斑水肿的发生率为18%。其高峰发生率在术后1个月,68%的患者在术后6个月时黄斑水肿自发消退。既往激光治疗可能在糖尿病患者白内障手术后2个月内预防术后黄斑水肿。然而,黄斑水肿并不影响糖尿病视网膜病变的严重程度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f93/3149133/6c76fa9bd824/kjo-25-238-g001.jpg

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