摘要：
Objective To investigate the incidence and risk factors of macular edema (ME) after cataract surgery in patients with type 2 diabetes mellitus (T2DM),and to provide a reference for clinical treatment.Methods From March 2014 to April 2017,128 cases of cataract phacoemulsification and intraocular lens implantation in Jincheng Ophthalmology Hospital were retrospectively analyzed,of whom 36 cases(36 eyes) without diabetes were A group,41 patients(41 eyes) with no retinopathy were B group,51 cases(51 eyes) of T2DM patients with retinopathy were C group.The incidence of ME,the BCVA and the CSMT of the three groups were compared,and the Logistic multiple factor regression analysis was used to analyze the risk factors of DME after T2DM cataract surgery.Results The incidence rates of ME in A,B and C group were 5.56％,29.27％ and 50.98％,respectively,and the difference was statistically significant (x2 =6.567,P ＜ 0.05),and that of C group ＞ B group ＞ A group (x2 =4.419,19.951,all P ＜0.05).The BCVA after operation in A group,B group and C group,was (0.26 ±0.08),(0.19± 0.04) and (0.08 ± 0.01),respectively,the difference was statistically significant (F =9.352,P ＜ 0.001),and that of group A ＞ group B ＞ group C (t =4.950,2.030,P ＜ 0.05).The CSMT after operation in A group,B group and C group was (246.35 ± 23.73) μm,(249.52 ± 20.95) μm and (289.31±43.82) μm,respectively,the difference was statistically significant (F =9.352,P ＜ 0.001).Logistic multivariate regression analysis showed that preoperative retinopathy [3.672 (0.261-0.961),P =0.000],preoperative ME [3.862 (0.136-0.769),P =0.001] were independent risk factors for the occurrence of ME after T2DM.Conclusion The incidence of ME is higher after T2DM cataract surgery,and the risk of ME is higher in patients with preoperative ME and preoperative diabetic retinopathy.%目的 探讨2型糖尿病(T2DM)患者白内障术后黄斑水肿(ME)的发生率以及危险因素,为临床治疗提供参考.方法 回顾性分析2014年3月至2017年4月晋城市眼科医院眼科收治的行白内障超声乳化联合人工晶体植入术患者128例,其中无糖尿病36例36只眼为A组,无视网膜病变的T2DM患者41例41只眼为B组,发生视网膜病变的T2DM患者51例51只眼为C组,比较三组患者术后ME发生率、最佳矫正视力(BCVA)、黄斑中心凹区域厚度(CSMT)的差异,logistic多因素回归分析T2DM白内障术后发生DME的危险因素.结果 A、B、C三组术后ME的发生率分别为为5.56％、29.27％、50.98％,差异有统计学意义(x2=6.567,P＜0.05),组间两两对比C组＞B组＞A组(x2=4.419,19.951,P＜0.05).A组、B组、C组术后BCVA分别为(0.26±0.08)、(0.19±0.04)、(0.08±0.01),差异有统计学意义(F =9.352,P＜0.001),组间两两比较A组＞B组＞C组(t=4.950,2.030,均P＜0.05).A组、B组、C组术后CSMT分别为(246.35±23.73) μm、(249.52±20.95) μm、(289.31±43.82) μm,差异有统计学意义(F=9.352,P＜0.001).logistic多因素回归分析显示术前视网膜病变[3.672(0.261～0.961),P=0.000]、术前ME[3.862(0.136～0.769),P=0.001]是影响T2DM术后ME发生的独立危险因素.结论 T2DM白内障术后ME发生率较高,术前ME、术前糖尿病视网膜病变患者白内障术后ME的发生风险较高.
