糖尿病患者白内障超声乳化术后角膜中央厚度与内皮细胞变化的相关性研究

Maha Yehia El-Sharaky, Omnia Osama El-Marakby, Alaa Amer El-Dorghamy, Mohamad Mostafa Kamal El-Saadany
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摘要

背景:糖尿病患者提供了一个特殊的问题,因为他们倾向于白内障的过早发展。本研究的目的是利用镜面显微镜检查糖尿病患者超声乳化术后的特征与术后角膜中央厚度(CCT)、角膜内皮细胞密度改变之间的关系。方法:本研究对40例行单纯超声乳化白内障摘除手术的患者进行队列研究。研究设计为前瞻性、选择性、非随机、干预性。参与者被分成两组,人数相等。在第一组中,患有复杂白内障的患者接受了成功的超声乳化手术,没有任何并发症。第二组为无糖尿病的老年性白内障行超声乳化术治疗,无并发症。结果:在非糖尿病和糖尿病患者中,术前角膜厚度(CCT)与变异系数(CV)呈正相关,与内皮细胞计数(ECC)负相关。糖尿病受试者与CCT呈负相关,健康受试者与CCT呈正相关。糖尿病组术后1、3个月CCT与ECC、HEX呈负相关,与CV呈正相关。最佳矫正视力(BCVA)最小分辨角(log MAR)的对数与中心CCT在术后1个月时呈正相关,在术后3个月时呈负相关。在非糖尿病组中,以对数形式表达的BCVA与CCT呈正相关。相反,CV与CCT呈负相关。CCT与HEX在术后3个月时呈正相关,术后1个月时呈负相关。术后1个月CCT与ECC呈正相关。然而,在术后3个月,CCT与ECC呈负相关。结论:非糖尿病人群和糖尿病人群超声乳化术后角膜内皮损失存在重要差异。糖尿病患者超声乳化术后内皮损伤明显加重。
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Correlation between postoperative central corneal thickness and endothelial changes after cataract surgery by phacoemulsification in diabetic patients
Background: Diabetic individuals provide a specific problem because to their propensity for the premature development of cataracts. The objective of this research is to examine the association among characteristics after phacoemulsification in diabetic individuals, and postoperative central corneal thickness (CCT), alterations in density of corneal endothelial cell using specular microscopy. Methods: This research was carried out on a cohort of forty individuals who had uncomplicated phacoemulsification surgery for the purpose of cataract extraction. The research design was prospective, selective non-randomized and interventional. The participants were allocated into two groups of equal size. In Group one, individuals with complex cataracts received a successful phacoemulsification procedure without any complications. Group two composed of non-diabetic individuals who received phacoemulsification for the treatment of senile cataract without any complications.Results: In both non-diabetic and diabetic individuals, the preoperative corneal thickness (CCT) exhibited a positive association with the coefficient of variation (CV) and a negative association with endothelial cell count (ECC). Diabetic subjects had a negative correlation with CCT while healthy subjects had a favorable one. One and three months after surgery, CCT was negatively correlated with ECC and HEX and positively correlated with CV in the diabetes group. The logarithm of minimum angle of resolution (log MAR) of best-corrected visual acuity (BCVA) exhibited a positive correlation with central CCT at the one-month postoperative mark, and a negative correlation at the three-month postoperative mark. In the non-diabetic group, there was a positive association observed among BCVA and CCT when expressed in log form. Conversely, a negative correlation was found among CV and CCT. The correlation among CCT and HEX was shown to be positive at the three-month stage of postoperative and negative at the first-month stage of postoperative. There was a positive correlation observed among CCT and ECC during the first-month postoperative period. However, at the three-month postoperative period, a negative correlation was found between CCT and ECC.Conclusions: There is an important variance of corneal endothelial loss after phacoemulsification between non-diabetic and diabetic population. Diabetic individuals demonstrated significantly more endothelial damage after phacoemulsification.
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