严重非增殖期糖尿病视网膜病变的白内障手术时机
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Operation timing of cataract surgery for severe non-proliferative diabetic retinopathy
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    摘要:

    目的:探讨严重非增殖期糖尿病视网膜病变的白内障手术时机。

    方法:严重非增殖期糖尿病视网膜病变患者120眼,按白内障手术时间分为三组。A组:未行全视网膜光凝; B组:全视网膜光凝≤3mo; C组:全视网膜光凝≥6mo。观察最佳矫正视力、用OCT评估术前、术后1,6mo的黄斑厚度、黄斑水肿发生率。

    结果:术后6mo,三组黄斑水肿的发生率分别为10.3%,30.6%,4.4%,B组分别与A组和C组相比,黄斑水肿发生率的差异有统计学意义(χ2=4.821,10.120; P<0.05)。同时,最佳矫正视力也明显低于其他两组,差异具有统计学意义(χ2=9.924,12.101; P<0.05)。

    结论:眼底光凝术后短期内施行白内障手术,有增加术后黄斑水肿的风险。

    Abstract:

    AIM: To investigate the operation timing of cataract surgery for severe non-proliferative diabetic retinopathy(NPDR).

    METHODS:Totally 120 eyes with severe NPDR were divided into 3 groups according to the timing of cataract surgery. Group A never treated with panretinal photocoagulation, and focal or grid macular laser. Group B was treated with panretinal photocoagulation and focal or grid macular laser for less than 3 months. Group C was treated with panretinal photocoagulation and focal or grid macular laser for more than 6 months. We examined the changes of macular thickness using OCT before cataract surgery and 1 month and 6-months after surgery. The central subfield mean thickness(CSMT)was used to evaluate macular edema which was defined as an increase of CSMT(ΔCSMT)> 30% from the baseline. We also analyzed the best-corrected visual acuity of the three groups.

    RESULTS: Macular edema occurred in 4 eyes(10.3%), 11 eyes(30.6%)and 2 eyes(4.4%)from the three groups respectively. 6 months after operation, compared to the A, C groups, macular edema from the group B were significantly different(χ2=4.821, 10.120; P<0.05). The best-corrected visual acuity of the group B was lower than the other groups(χ2=9.924, 12.101; P<0.05).

    CONCLUSION: After treated with panretinal photocoagulation within short-term, cataract surgery might improve the risk of postoperative macular edema.

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张祺,冯劼,程旭康,等.严重非增殖期糖尿病视网膜病变的白内障手术时机.国际眼科杂志, 2013,13(1):92-93.

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  • 收稿日期:2012-06-25
  • 最后修改日期:2012-12-15
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