糖尿病患者白内障超声乳化人工晶状体植入术的临床观察

目的：观察糖尿病患者白内障超声乳化吸出联合人工晶状体植入术的临床疗效。方法：选择36例(36眼)糖尿病患者行白内障超声乳化吸出联合人工晶状体植入术，并设36例(36眼)老年性白内障患者行白内障超声乳化吸出联合人工晶状体植入术为对照。结果：糖尿病患者白内障术后角膜内皮水肿、房水混浊、纤维素样渗出、瞳孔后粘连、后囊混浊等前段手术并发症发生率高于老年性白内障，但经过正确处理，总体预后两组并无显著性差异。结论：糖尿病患者空腹血糖控制在8．33mmoL／L以下时，行白内障超声乳化吸出联合人工晶状体植入是安全的：术中尽量减少器械在前房的操作次数，减少对角膜内皮和虹膜的损伤，能有效减少术后并发症的发生；术后使用激素眼药水滴眼，有效活动瞳孔，是治疗糖尿病患者白内障人工晶状体植入术后并发症的有效措施。

Clinical Observation of Phacoemulsification and Lens Implantation in Patients with Diabetes Mellilus

Purpose: To investigate the clinical results of phacoemulsification and posterior chamber lens implantation in diabetic patients. Methods:Thirty-six eyes of 36 consecutive patients with diabetic cataract who had cataract surgery with phacoemulsification and posterior chamber lens implantation were prospectively followed up.The outcomes were compared with 36 eyes of 36 senile cataract patients with the same surgery. Results :The complications of anterior segments of diabetic cataract, such as corneal edema, anterior chamber flare and fibrinous exubates, iris posterior synechiae, and posterior capsule opaque,were significant higher than those of senile cataract at early stage after surgery.There was no significant difference for the last results between two groups by treatment. Conclusions : Phacoemulsification and posterior chamber lens implantation seem to have no influence on the prognosis of diabetic cataract when fasting venous plasma glucose was controlled under 8.33mmol/L.Reducing movement of instruments in the anterior chamber and damage to endothelium and iris could effectively reduce the rate of complication.Intensive topical steroid and suitable dilating eye drops were effective therapeutic methods for the complications.