Clinical Study Of Posterior Capsular Opacification After Cataract Surgery In Diabetic Patients

Objection:To study the occurrence and development of posterior capsular opacification（PCO）after cataract surgery in diabetic patients,and to explore the related risk factors affecting the occurrence of PCO in diabetic patients.To understand the relationship between diabetes mellitus and the occurrence and development of PCO,so as to better predict and evaluate the occurrence and progress of PCO in diabetic patients after cataract surgery,and provide guidance and Suggestions for clinical work.Methods:A prospective case-control study.Clinical data of 182 cases（203 eyes）who underwent cataract phacoemulsification combined with intraocular lens implantation in our hospital from April 2016 to August 2016 were collected.Patients who met the inclusion criteria were included in 90 cases（98 eyes）of diabetes group（DM group）and 92 cases（105eyes）of non-diabetes group（non-DM group）.Patients in the two groups were followed up to observe the incidence of PCO at 12,18,24 and 30 months after cataract surgery,and the PCO degree was graded.Chi-square test was used to compare the incidence of PCO in the two groups,and rank-sum test was used to compare the grading of PCO in the two groups at different follow-up times after cataract surgery.Ninety patients（98 eyes）in DM group were divided into groups according to whether PCO occurred 30 months after cataract surgery,24patients（26 eyes）in PCO group,and 66 patients（72 eyes）in non-PCO group.Chi-square test was used to screen related risk factors,and multivariate logistic regression analysis was used to analyze and screen independent risk factors in diabetic patients with PCO.To study the correlation between preoperative diabetic duration,HbA1c level,preoperative diabetic retinopathy（DR）and PCO.SPSS 24.0 statistical software was used for statistical analysis.Results:There were no statistically significant differences in age,gender,eye size and axial length between the DM group and the non-DM group.The incidence of PCO at 12,18,24and 30 months after cataract surgery in DM group was 10.2%,14.3%,22.4%and 26.5%.The incidence of PCO at 12,18,24 and 30 months after cataract surgery in non-DM group was 3.9%,4.8%,10.5%and 14.3%.With the extension of follow-up time after cataract surgery,the incidence of PCO in both groups increased gradually,and the incidence of PCO at all time points in the diabetic group was higher than that in the non-diabetic group,and the difference between the two groups was statistically significant(?²_12M=4.565,P_12M=0.033;?²_18M=5.420,P_18M=0.020;?²_24M=5.338,P_24M=0.021;?²_30M=4.715,P_30M=0.030).With the extension of follow-up time,the degree of PCO in both groups gradually increased,and the degree of PCO in the diabetes group at all time points was greater than that in the non-diabetes group,and the difference between the two groups was statistically significant(Z_12M=-2.148,P_12M=0.032;Z_18M=-2.323,P_18M=0.020;Z_24M=-2.386,P_24M=0.017;Z_30M=-2.278,P_30M=0.023).The chi-square test was used for univariate analysis,and the related factors of PCO in DM group were screened.The results showed that preoperative diabetes duration,combined DR were correlated to PCO（diabetes duration:?²=9.237,P=0.002;DR:?²=7.724,P=0.005）,and preoperative HbA1c level has nothing to do with the occurrence of PCO（?²=0.678,P=0.409）.Taking PCO as the dependent variable,diabetes duration、HbA1c、DR as the independent variable,multivariate logistic regression analysis was performed to analyze the independent risk factors.The results showed that preoperative duration of diabetes mellitus was>10 years（OR=3.216,P=0.023）,and preoperative presence of DR（OR=2.972,P=0.032）were independent risk factors affecting the occurrence of PCO.Conclusion:Diabetes mellitus can promote the occurrence and development of PCO.The incidence of posterior capsular opacification after cataract surgery in diabetic patients was higher than that in non-diabetic patients,and the opacification degree was higher.Preoperative diabetes duration and DR are related to the occurrence of PCO,and preoperative HbA1c level is unrelated to the occurrence of PCO.Preoperative diabetes duration>10 years and preoperative presence of DR are independent risk factors for PCO in patients with diabetes mellitus.