Diabetes and postcataract extraction endophthalmitis.
Diabetes and postcataract extraction endophthalmitis.
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DOI：
10.1097/00055735-200206000-00003
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发表时间：
2002-06-01
影响因子：
3.7
通讯作者：
Groer-Fitzgerald, Shirley
中科院分区：
文献类型：
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作者：
Doft, Bernard H;Wisniewski, Stephen R;Groer-Fitzgerald, Shirley
本文报道了在眼内炎玻璃体切除术研究中对患者进行探索性分析的结果，以确定糖尿病患者对治疗是否有不同的反应，以及糖尿病患者和非糖尿病患者眼内炎的体征和症状是否不同。在这项多中心临床试验中，患者在随机分配玻璃体切除术或穿刺/活检后随访9个月。结果测量包括以标准化方式评估的视力。420名研究患者中有58名患有糖尿病。糖尿病患者表现为视力和眼介质稍差。只有39%的糖尿病患者和55%的非糖尿病患者达到了20/40的最终视力。无论是糖尿病患者还是非糖尿病患者，仅表现为光感（LP）的患者，立即玻璃体切除术后视力均有较好的效果。对于那些表现优于LP视力的患者，糖尿病患者玻璃体切除术（57%）比穿刺/活检（40%）达到20/40，但非糖尿病患者玻璃体切除术或穿刺/活检的效果相同。在糖尿病组中，由于数量少，没有足够的统计能力来检验治疗差异。需要一项新的临床试验来确定糖尿病和非糖尿病患者对治疗的反应是否存在差异，这些患者的视力优于LP。
This paper reports the results of an exploratory analysis among patients in the Endophthalmitis Vitrectomy Study to determine if there was a different response to treatment in diabetes and whether the signs and symptoms of endophthalmitis differ between diabetic and nondiabetic patients. Patients in this multicenter clinical trial were followed for 9 months after random assignment to either vitrectomy or tap/biopsy. Outcome measures included visual acuity assessed in standardized fashion. Fifty-eight of 420 study patients were diabetic. Diabetics presented with slightly worse vision and ocular media. Only 39% of diabetics compared with 55% of nondiabetics achieved 20/40 final vision. Both diabetic and nondiabetic patients who presented with vision of only light perception (LP) had better visual results with immediate vitrectomy. For those who presented with better than LP vision, diabetics achieved 20/40 more often with vitrectomy (57%) than with tap/biopsy (40%), but non diabetics did equally well with vitrectomy or tap/biopsy. In the diabetic group, small numbers did not allow adequate statistical power to test treatment difference. A new clinical trial is needed to determine if in fact there is a difference in response to treatment among diabetic and nondiabetic patients who present with better than LP vision.