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目的分析合并糖尿病视网膜病变(diabetic reti-nopathy,DR)和不合并DR的患者施行白内障超声乳化术后黄斑水肿的变化。方法收集拟施行白内障超声乳化术的合并和不合并DR的患者各34眼。用光学相干断层扫描技术测定术前,术后3个月、6个月、12个月患者的中心凹厚度及黄斑体积。同时检测糖尿病性黄斑水肿的程度。结果术前两组患者中心凹厚度及黄斑体积差异均无统计学意义。术后3个月,合并DR组患者中心凹厚度增加了20.3%,没有合并DR组患者增加了6.0%,但随后两组中心凹厚度均逐渐降低。术后3个月时,合并DR组的中心凹厚度和黄斑体积均较没有合并DR组明显增高。DR组黄斑水肿程度加重者8眼(23.5%),而没有DR组1眼(2.9%),2组相比差异有统计学意义(P=0.0272)。但是,9眼中3眼(33.3%)术后水肿自发消退。结论白内障术后糖尿病性黄斑水肿程度加重,3个月后逐渐降低。其分级亦加重直到术后3个月,但术后部分黄斑水肿会自发消退。所有这些改变DR组均较明显。
Objective To analyze the changes of macular edema after cataract phacoemulsification in patients with diabetic reti-nopathy (DR) and without DR. Methods We collected 34 eyes of 34 patients with and without DR who were scheduled for phacoemulsification. Optical coherence tomography was used to determine the fovea thickness and macular volume before, 3 months, 6 months and 12 months postoperatively. At the same time detect the degree of diabetic macular edema. Results There was no significant difference in foveal thickness and macular volume between the two groups before operation. At 3 months after operation, the fovea thickness increased by 20.3% in patients with DR and 6.0% in patients without DR, but the fovea thickness gradually decreased in both groups. At 3 months after operation, the foveal thickness and macular volume in the combined DR group were significantly higher than those in the non-combined DR group. The severity of macular edema in DR group was 8 eyes (23.5%), but no DR group (2.9%), the difference was statistically significant (P = 0.0272). However, postoperative edema resolved spontaneously in 3 eyes (33.3%) of 9 eyes. Conclusion The degree of diabetic macular edema increased after cataract surgery and gradually decreased after 3 months. The grade also increased until 3 months after surgery, but some macular edema subsided spontaneously. All of these changes in the DR group were more pronounced.