Diabetic retinopathy before and after cataract surgery
Diabetic retinopathy before and after cataract surgery
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DOI：
10.1136/bjo.80.9.789
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发表时间：
1996-09-01
影响因子：
4.1
通讯作者：
Janzon, L
中科院分区：
文献类型：
--
作者：
Henricsson, M;Heijl, A;Janzon, L
目的/背景-糖尿病患者白内障手术后视网膜病变进展增加。为了评估白内障手术对视力和视网膜病变进展的影响，在赫尔辛堡眼科对1991- 1993年期间接受白内障手术的所有糖尿病患者进行了随访。平均随访时间为2year.Methods-70例患者中的每一个的一只眼睛被包括在研究中，35单眼和35双眼手术on. Sixteen的70例患者有增殖性糖尿病视网膜病变（PDR）在基线。视网膜病变分级采用威斯康星州量表。通过测量HbA（1c）来评估血糖控制程度。结果-大多数患者获得了视力改善; 89%的糖尿病手术眼术后视力达到0.5或更好。视网膜病变的进展发生在70只眼睛中的30只，并且与平均HbA（1c）水平（p=0.04）、糖尿病持续时间（p=0.02）、胰岛素治疗（p=0.001）和基线时视网膜病变的存在（p=0.01）相关。进展患者的黄斑水肿发生率显著高于未进展患者（p=0.006）。35例单眼手术患者手术眼与非手术眼比较，差异无统计学意义。两名患者在这一组中，然而，最终与黄斑水肿和视力较差的手术眼比眼睛没有operatedon.Conclusions -在这项研究中，也与PDR的患者，获得良好的视力，优于在大多数以前的研究。血糖控制不良是白内障术后糖尿病视网膜病变进展的重要因素。
Aims/background - Increased retinopathy progression has been reported after cataract surgery in patients with diabetes mellitus. To assess the influence of cataract surgery on visual acuity and retinopathy progression, all diabetic patients who were subjected to cataract surgery during 1991-3 have been followed up at the Department of Ophthalmology in Helsingborg. The average follow up time was 2 years.Methods - One eye of each of 70 patients was included in the study, 35 monocularly and 35 binocularly operated on. Sixteen of the 70 patients had proliferative diabetic retinopathy (PDR) at baseline. The Wisconsin scale was used for the grading of retinopathy. The degree of glycaemic control was assessed by measurements of HbA(1c).Results - Most patients obtained improved visual acuity; a postoperative visual acuity of 0.5 or better was achieved in 89% of diabetic surgical eyes. Progression of the retinopathy occurred in 30 out of the 70 eyes, and was associated with mean level of HbA(1c) (p=0.04), duration of diabetes (p=0.02), insulin treatment (p=0.001), and presence of retinopathy at baseline (p=0.01). Patients who progressed had a significantly higher incidence of macular oedema (p=0.006) than those who did not progress. No significant differences were found when operated and non-operated eyes were compared in the 35 patients with monocular surgery. Two patients in this group, however, ended up with macular oedema and worse vision in the operated eye than in the eye which was not operated on. Both patients had background retinopathy before surgery.Conclusions - Patients in this study, also those with PDR, obtained good visual acuity, better than in most previous studies. Poor glycaemic control was a factor of importance for the progression of diabetic retinopathy after cataract surgery.