Ding Rui, Wu BaoHua, Sun Yan, Zhang XiaoYan, Mi HaiZhou, Kong YueRong, Ma YanGang
Department of Cataract Specialist, Lanzhou Bright Eyesight Hospital, Lanzhou City, Gansu Province, 730050, People's Republic of China.
Clin Ophthalmol. 2025 Mar 31;19:1129-1138. doi: 10.2147/OPTH.S506122. eCollection 2025.
Macular edema and retinal thickening after cataract surgery can lead to poor vision in patients, especially in the presence of high glucose. Blood glycosylated hemoglobin (HbA1c) concentration plays an important role in assessing diabetic control and is closely related to cataract surgery prognosis. The aim of this study was to investigate the correlation between postoperative HbA1c levels and postoperative cystoid macular edema (CME) and central macular thickness (CMT) in diabetic cataract patients.
Retrospective analysis was conducted on 80 patients with diabetic cataracts from December 2018 to December 2023. The enrolled cases were divided into 2 groups according to the blood glucose control: 56 cases (56 eyes) in the intensive treatment group (HbA1c ≤ 7.0%) with insulin combined with oral hypoglycemic agents; and 24 cases (24 eyes) in the standard treatment group (HbA1c > 7.0%). The Student's -test or paired -test was used to compare the changes in CMT between the two groups at each preoperative and postoperative time period. The chi-square test was used to compare the incidence of CME at each postoperative time period. Pearson or Spearman correlation was used to analyse the relationship between HbA1c levels and CMT or CME at each postoperative time period. Predictive efficacy was analyzed using ROC curves.
Patients who went through the standard treatment showed significant CMT thickening and CME at 3 and 6 months postoperatively. HbA1c levels were positively correlated with CME and CMT at 1, 3, and 6 months postoperatively, with good predictive efficacy.
Postoperative HbA1c levels have a strong correlation with CME and CMT thickening and may be reliable and valid biomarkers.
白内障手术后黄斑水肿和视网膜增厚会导致患者视力下降，尤其是在高血糖情况下。糖化血红蛋白（HbA1c）浓度在评估糖尿病控制情况中起重要作用，且与白内障手术预后密切相关。本研究旨在探讨糖尿病性白内障患者术后HbA1c水平与术后黄斑囊样水肿（CME）及黄斑中心厚度（CMT）之间的相关性。
对2018年12月至2023年12月期间的80例糖尿病性白内障患者进行回顾性分析。根据血糖控制情况将纳入病例分为2组：强化治疗组56例（56眼），HbA1c≤7.0%，采用胰岛素联合口服降糖药治疗；标准治疗组24例（24眼），HbA1c>7.0%。采用Student's t检验或配对t检验比较两组术前及术后各时间段CMT的变化。采用卡方检验比较术后各时间段CME的发生率。采用Pearson或Spearman相关性分析术后各时间段HbA1c水平与CMT或CME之间的关系。使用ROC曲线分析预测效能。
接受标准治疗的患者术后3个月和6个月CMT显著增厚且出现CME。术后1个月、3个月和6个月时，HbA1c水平与CME及CMT呈正相关，预测效能良好。
术后HbA1c水平与CME及CMT增厚密切相关，可能是可靠有效的生物标志物。
