Liu Jianping, Jones Richard Edward, Zhao Jiangyue, Zhang Jinsong, Zhang Fan
Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China; Eye Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China; Key Lens Research Laboratory of Liaoning Province, Shenyang, Liaoning, People's Republic of China.
Department of Ophthalmology and Vision Science, University of Arizona College of Medicine, Tucson, Arizona, United States of America.
PLoS One. 2015 May 12;10(5):e0126343. doi: 10.1371/journal.pone.0126343. eCollection 2015.
To evaluate the effect of uncomplicated phacoemulsification on central macular thickness (CMT) and best corrected visual acuity (BCVA) in both diabetic patients without diabetic retinopathy (DR) and diabetic patients with mild to moderate non-proliferative diabetic retinopathy (NPDR).
Potential prospective observational studies were searched through PubMed and EMBASE. Standardized mean difference (SMD) and 95% confidence interval (CI) for changes in CMT and BCVA were evaluated at postoperative 1, 3 and 6 months. The pooled effect estimates were calculated in the use of a random-effects model.
A total of 10 studies involving 190 eyes of diabetic patients without diabetic retinopathy and 143 eyes of diabetic patients with NPDR were identified. CMT values demonstrated a statistically significant increase after uncomplicated phacoemulsification at 1 month (SMD, -0.814; 95%CI, -1.230 to -0.399), 3 months (SMD, -0.565; 95%CI, -0.927 to -0.202) and 6 months (SMD, -0.458; 95%CI, -0.739 to -0.177) in diabetic patients with NPDR. There was no statistical difference in CMT values at postoperative 1 month (SMD, -1.206; 95%CI, -2.433 to 0.021)and no statistically significant increase in CMT values at postoperative3 months (SMD, -0.535; 95%CI, -1.252 to 0.182) and 6 months (SMD, -1.181; 95%CI, -2.625 to 0.263) in diabetic patients without DR.BCVA was significantly increased at postoperative 1 month (SMD, 1.149; 95%CI, 0.251 to 2.047; and SMD,1.349; 95%CI, 0.264 to 2.434, respectively) and 6 months (SMD, 1.295; 95%CI, 0.494 to 2.096; and SMD, 2.146; 95%CI, 0.172 to 4.120, respectively) in both diabetic patients without DR and diabetic patients with NPDR. Sensitivity analysis showed that the results were relatively stable and reliable.
Uncomplicated phacoemulsification in diabetic patients with mild to moderate NPDR seemed to influence significantly the subclinical thickening of the macular zones at postoperative 1, 3 and 6 months compared with diabetic patients without DR. BCVA was significantly improved in both diabetic patients without DR and diabetic patients with mild to moderate NPDR.
评估单纯白内障超声乳化术对无糖尿病视网膜病变（DR）的糖尿病患者以及轻度至中度非增殖性糖尿病视网膜病变（NPDR）的糖尿病患者的黄斑中心厚度（CMT）和最佳矫正视力（BCVA）的影响。
通过PubMed和EMBASE检索潜在的前瞻性观察性研究。在术后1、3和6个月评估CMT和BCVA变化的标准化平均差（SMD）和95%置信区间（CI）。采用随机效应模型计算合并效应估计值。
共纳入10项研究，涉及190只无DR的糖尿病患者的眼睛和143只患有NPDR的糖尿病患者的眼睛。在患有NPDR的糖尿病患者中，单纯白内障超声乳化术后1个月（SMD，-0.814；95%CI，-1.230至-0.399）、3个月（SMD，-0.565；95%CI，-0.927至-0.202）和6个月（SMD，-0.458；95%CI，-0.739至-0.177）时，CMT值显示出统计学上的显著增加。在无DR的糖尿病患者中，术后1个月CMT值无统计学差异（SMD，-1.206；95%CI，-2.433至0.021），术后3个月（SMD，-0.535；95%CI，-1.252至0.182）和6个月（SMD，-1.181；95%CI，-2.625至0.263）时CMT值无统计学上的显著增加。在无DR的糖尿病患者和患有NPDR的糖尿病患者中，术后1个月（SMD分别为1.149；95%CI，0.251至2.047；以及SMD，1.349；95%CI，0.264至2.434）和6个月（SMD分别为1.295；95%CI，0.494至2.096；以及SMD，2.146；95%CI，0.172至4.120）时BCVA均显著提高。敏感性分析表明结果相对稳定可靠。
与无DR的糖尿病患者相比，轻度至中度NPDR的糖尿病患者进行单纯白内障超声乳化术似乎在术后1、3和6个月对黄斑区的亚临床增厚有显著影响。无DR的糖尿病患者和轻度至中度NPDR的糖尿病患者的BCVA均显著改善。
