Kim Eun Chul, Hwang Ho Sik, Kim Man Soo
Department of Ophthalmology & Visual Science, College of Medicine, Catholic University of Korea, Seoul, Korea.
Semin Ophthalmol. 2013 Mar;28(2):68-71. doi: 10.3109/08820538.2012.754480.
To report a case of complete occlusion of the capsulorhexis opening in a DM patient with high hemoglobin A1C level.
A 77-year-old woman with non-insulin-dependent diabetes underwent uncomplicated phacoemulsification in both eyes. One year later, she presented again because of reduced vision (best-corrected visual acuity of 16/20 in the right eye, 6/20 in the left eye). Dilated examination revealed marked anterior capsular contraction in the right eye and anterior capsular phimosis totally occluding the capsulorhexis opening in the left eye.
The severity of diabetic retinopathy and her fasting blood sugar (225 mg/dl) and hemoglobin A1C level (8.5%) increased during the previous year. Uncorrected visual acuity of 18/20 (OS) was achieved after a neodymium:YAG (Nd:YAG) radial anterior capsulotomy was performed.
Microvascular complications such as diabetic retinopathy or diabetic iritis can occur in patient with uncontrolled diabetes mellitus. The pathophysiology of anterior capsular phimosis in this patient is probably increased vascular permeability chronically associated with diabetes.
报告1例糖化血红蛋白水平高的糖尿病患者囊膜撕开开口完全闭塞的病例。
一名77岁非胰岛素依赖型糖尿病女性双眼接受了无并发症的超声乳化白内障吸除术。一年后，她因视力下降再次就诊（右眼最佳矫正视力为16/20，左眼为6/20）。散瞳检查发现右眼有明显的前囊膜收缩，左眼有前囊膜狭窄，完全闭塞了囊膜撕开开口。
在过去一年中，糖尿病视网膜病变的严重程度以及她的空腹血糖（225mg/dl）和糖化血红蛋白水平（8.5%）均有所增加。在进行钕:钇铝石榴石（Nd:YAG）放射状前囊膜切开术后，未矫正视力达到了18/20（左眼）。
糖尿病视网膜病变或糖尿病性虹膜炎等微血管并发症可能发生在糖尿病控制不佳的患者中。该患者前囊膜狭窄的病理生理学可能是长期与糖尿病相关的血管通透性增加。
