Alpar J J
J Am Intraocul Implant Soc. 1984 Fall;10(4):433-7. doi: 10.1016/s0146-2776(84)80042-7.
A prospective study of the effect of cataract extraction and intraocular lens implantation on insulin-dependent diabetics is presented. Cataract extraction was performed on 138 patients with diabetic retinopathy. The patients were randomly selected for intracapsular or extracapsular extraction and for the administration of topical indomethacin or placebo. In a second group, 103 diabetic patients received intraocular lens implants, which were anterior-chamber-angle fixated, iris supported, iridociliary sulcus supported, or placed in the capsular bag. Random selection determined who among the extracapsular cases would have on-the-table capsulotomy or six-month-postoperative capsulotomy. The study indicated that a greater progression of diabetic changes occurred in both the posterior and the anterior segment of the eye after intracapsular extraction than after extracapsular extraction, especially if the capsulotomy was performed six months postoperatively. Furthermore, the study indicated that in-the-bag implantation without on-the-table capsulotomy was a safe procedure; anterior-chamber-angle-fixated lenses exhibited a higher incidence of diabetic changes in the anterior and posterior segments than the other lenses.
本文介绍了一项关于白内障摘除及人工晶状体植入对胰岛素依赖型糖尿病患者影响的前瞻性研究。对138例糖尿病性视网膜病变患者进行了白内障摘除术。患者被随机选择进行囊内或囊外摘除，并给予局部吲哚美辛或安慰剂。在第二组中，103例糖尿病患者接受了人工晶状体植入，植入的人工晶状体为前房角固定型、虹膜支撑型、虹膜睫状体沟支撑型或置于囊袋内。随机选择决定了囊外手术病例中哪些患者将进行术中囊切开术或术后6个月囊切开术。研究表明，囊内摘除术后眼后段和前段的糖尿病性病变进展比囊外摘除术后更严重，尤其是在术后6个月进行囊切开术时。此外，研究表明，不进行术中囊切开术的囊袋内植入是一种安全的手术；前房角固定型人工晶状体在前段和后段出现糖尿病性病变的发生率高于其他类型的人工晶状体。
