Yi Guilan, Yu Hai
Department of Ophthalmology, Deyang People's Hospital, Deyang, China.
Department of Ophthalmology, Deyang People's Hospital, No. 173 Taishan North Road, Jingyang District, Deyang City, Sichuan Province, 61800, P.R. China.
BMC Ophthalmol. 2025 Apr 28;25(1):252. doi: 10.1186/s12886-025-04080-1.
This study aims to identify the risk factors associated with pupillary changes in patients with diabetic retinopathy (DR) and cataract undergoing phacoemulsification with intraocular lens implantation (PHACO + IOL).
This retrospective observational study included patients with DR and cataract who underwent phacoemulsification and intraocular lens implantation between February 2021 and August 2023. Patients were categorized into two groups based on the presence or absence of pupillary changes following surgery.
A total of 162 patients were analyzed, with pupillary changes occurring in 33 cases (20.37%). Multivariate logistic regression analysis revealed that a longer duration of diabetes (OR = 2.73; 95% CI: 1.02-7.27, P = 0.045), higher lens nucleus grade (OR = 3.95; 95% CI: 1.58-9.89, P = 0.003), greater severity of DR (OR = 3.60; 95% CI: 1.40-9.28, P = 0.008), and intraoperative posterior lens capsule rupture (OR = 6.41; 95% CI: 1.75-23.47, P = 0.005) were significant risk factors for postoperative pupillary changes in DR patients undergoing PHACO + IOL.
Phacoemulsification with intraocular lens implantation is an effective treatment for patients with DR and cataract. However, factors such as the duration of diabetes, severity of DR, and intraoperative complications are associated with an increased risk of pupillary changes. Therefore, rigorous blood glucose control, adherence to standardized surgical protocols, and preventive care are recommended to optimize patient outcomes.
Not applicable.
Not applicable.
本研究旨在确定糖尿病视网膜病变（DR）合并白内障患者行超声乳化白内障吸除联合人工晶状体植入术（PHACO + IOL）后瞳孔变化的相关危险因素。
这项回顾性观察性研究纳入了2021年2月至2023年8月期间行超声乳化白内障吸除和人工晶状体植入术的DR合并白内障患者。根据术后是否出现瞳孔变化将患者分为两组。
共分析了162例患者，其中33例（20.37%）出现瞳孔变化。多因素logistic回归分析显示，糖尿病病程较长（OR = 2.73；95%CI：1.02 - 7.27，P = 0.045）、晶状体核分级较高（OR = 3.95；95%CI：1.58 - 9.89，P = 0.003）、DR严重程度较高（OR = 3.60；95%CI：1.40 - 9.28，P = 0.008）以及术中晶状体后囊破裂（OR = 6.41；95%CI：1.75 - 23.47，P = 0.005）是行PHACO + IOL的DR患者术后瞳孔变化的显著危险因素。
超声乳化白内障吸除联合人工晶状体植入术是治疗DR合并白内障患者的有效方法。然而，糖尿病病程、DR严重程度及术中并发症等因素与瞳孔变化风险增加相关。因此，建议严格控制血糖、遵循标准化手术方案及进行预防性护理以优化患者预后。
不适用。
不适用。
