围手术期血糖控制对糖尿病视网膜病变和黄斑病变进展的影响

来源 :世界核心医学期刊文摘.眼科学分册 | 被引量 : 0次 | 上传用户:yanhuo68
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Objective: To evaluate the contribution of perioperative glycemic control to progression of diabetic retinopathy and maculopathy. Methods: Postoperative progression of diabetic retinopathy and maculopathy were compared in 87 patients with type 2 diabetesmellitus who underwentmonocular phacoemulsification cataract surgery performed by a single surgeon. Twenty-seven patients had had poor glycemic control preoperatively and underwent rapid preoperative glycemic correction;30 patients had poor control preoperatively that was not corrected postoperatively; and 30 patients had good preoperative glycemic control. The grade of diabetic retinopathy and maculopathy in the operated-on eye and the fellow eye was assessed preoperatively and for 12 months postoperatively. Results: There were no significant differences in the progression rate of diabetic retinopathy among the 3 groups (P = .27). However, the progression rate of diabetic maculopathy was significantly higher in the group that underwent rapid control than in the other 2 groups (P = .02). Patients with moderate to severe nonproliferative diabetic retinopathy preoperatively in the rapid control group had significantly higher progression rates of diabetic retinopathy and maculopathy (P = .002 and .008, respectively). Conclusions: Rapid preoperative glycemic control should be avoided in patients with moderate to severe nonproliferative diabetic retinopathy because it may increase the risk of postoperative progression of retinopathy and maculopathy. Objective: To evaluate the contribution of perioperative glycemic control to progression of diabetic retinopathy and maculopathy. Methods: Postoperative progression of diabetic retinopathy and maculopathy were compared in 87 patients with type 2 diabetes mellitus who underwent monocular phacoemulsification cataract surgery performed by a single surgeon. Twenty-seven 30 patients with poor control preoperatively that was not corrected postoperatively; and 30 patients had good preoperative glycemic control. The grade of diabetic retinopathy and maculopathy in the operated-on eye and the Results: There were no significant differences in the progression rate of diabetic retinopathy among the 3 groups (P = .27). However, the progression rate of diabetic maculopathy was significantly higher in the group that underwent Rapid control than in the other 2 groups (P = .02). Patients with moderate to severe nonproliferative diabetic retinopathy preoperatively in the rapid control group had significantly higher progression rates of diabetic retinopathy and maculopathy (P = .002 and .008, respectively) Conclusions: Rapid preoperative glycemic control should be avoided in patients with moderate to severe nonproliferative diabetic retinopathy because it may increase the risk of postoperative progression of retinopathy and maculopathy.
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