| Objective: To investigate the changes of macular central retinal thickness(FT)after phacoemulsification and intraocular lens implantation in patients with type 2diabetes mellitus and its relationship with postoperative best corrected visual acuity(BCVA).Methods: A total of 60 patients who met the inclusion criteria from January 2017 to September 2017 were selected.All of them required phacoemulsification and intraocular lens implantation for phacoemulsification.Thirty patients(30 eyes)with type 2 diabetes combined with cataract surgery were included in the study.In the group,30 cases(30 eyes)of age-related cataract patients were the control group.All patients underwent frequency-domain optical coherence tomography(OCT)and best-corrected visual acuity(BCVA)before surgery and 1 day,1 week,1 month,and 3 months after surgery.The macular foveal retinal thickness before and after surgery was observed and compared.The relationship between macular foveal retinal thickness and best corrected visual acuity was investigated.The incidence of macular edema was compared between th e tw o gr o u p s.SP S S 1 9.0 so f t w a r e wa s us e d for in d e x an a l y s i s.Results: A total of 60 patients(60 eyes)were followed up,including 30 cases(30eyes)in the experimental group and 30 cases(30 eyes)in the control group.The age between the two groups(t =-0.62,P = 0.54> 0.05);Sex(χ2=0.67,P=0.80>0.05);There was no statistical difference in general basic data of hypertension(χ2=1.09,P= 0.3 0> 0.0 5).Th er e wa s co m pa r a bi l i t y be t w ee n th e two gr o u ps.1.The retinal thickness of macular fovea before surgery in each group was:experimental group: 216.40±19.44 μm;control group: 211.77±16.61 μm.There was no statistical difference between the two groups(P>0.05).2.Postoperative macular foveal retinal thickness(FT): intragroup comparison:There was no statistical difference between the control group and the preoperative time(P>0.05).The experimental group was compared with preoperative: There was no significant change in FT on the 1st day after surgery,and the difference was not statistically significant(P>0.05).The FT was thickened at 1 week,1 month,and 3months postoperatively,with statistical difference(P< 0.05).Comparison betweengroups: In the experimental group,FT was thicker at 1 week,1 month and 3 months after the operation than that of the control group(P<0.05).The highest value of FT increase in the experimental group occurred at 1 month after the operation.3.Two groups of BCVA: The postoperative BCVA increased in both groups,and there was a statistically significant difference compared with preoperative(P<0.05).There was no statistical difference between the two groups(P>0.05).BCVA of the experimental group was significantly worse than that of the control group at 1 month and 3 months after surgery(P<0.05).Within-group comparisons: There was no significant difference in BCVA between the control group at each time point(Z=-1.84,0.00,0.00,p>0.05);The experimental group was postoperative 1 week and postoperative 1 day,postoperative 3 months Compared with one month after operation,there was no statistical difference(Z=0,-1.81,P>0.05).The difference between January1 and postoperative 1 week was statistically significant(Z=-3.78,P<0.01).4.Correlation between macular foveal retinal thickness(FT)and best corrected visual acuity(BCVA): There was a positive correlation between logMAR BCVA and FT in the experimental group at 1 month and 3 months after operation(P<0.05).There was no correlation between logMRABCVA and FT at all time points in the control group(P>0.05).5.Macular edema occurred in 5 eyes(5/30)in the experimental group,and macular edema(0/30)did not appear in the control group.The incidence of macular edema in the experimental group(16.67%)was higher than that in the control group(0%).The difference was not statistically significant(P>0.05).The logMRABCVA and FT in patients with macular edema in the experimental group were higher than those without macular edema,and the differences were statistically significant(P<0.01).There was a positive correlation between FT and logMRABCVA in patients with macular edema(P<0.05).Conclusion: 1.Diabetic patients after phacoemulsification cataract extraction combined with intraocular lens implantation,macular foveal retinal thickness increased significantly,the incidence of macular edema during follow-up was higher than that of simple cataract patients.2.The best corrected visual acuity(BCVA)improved after surgery in both groups,but BCVA in some diabetic patients showed a marked decrease again during follow-up.3.The recovery of best corrected visual acuity in diabetic patients with macularedema after cataract surgery is significantly affected.Before the operation,the patient should communicate with the patient in detail to obtain the patient’s understanding and take appropriate preventive measures. |
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