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目的 分析糖尿病患者白内障摘除联合后房型人工晶状体植入术的临床疗效。方法 自 1992年至2 0 0 1年共完成 5 9例 (5 9只眼 )糖尿病患者白内障摘除联合后房型人工晶状体植入术 ,现以 5 9例 (5 9只眼 )非糖尿病患者白内障摘除联合后房型人工晶状体植入术作为对照 ,两组患者均植入肝素表面处理的后房型人工晶状体。全部病例均采用常规 ECCE术式。结果 糖尿病组术后并发角膜水肿 19例 ,纤维渗出 10例 ,瞳孔后粘连 14例 ,后囊混浊 2 7例 ,黄斑囊样变性 8例。而糖尿病组与非糖尿病术后矫正视力无显著差异。结论 虽然糖尿病患者进行人工晶状体手术已不在是禁忌 ,但使术前和术后患者的空腹血糖应控制在 5 .1~ 8.0 mmol/ L 之间。术中尽量减少器械在前房内的操作次数 ,减少对角膜内皮和虹膜的损伤。将残留的晶状体皮质和粘弹剂冲吸干净 ,以减少术后的炎症反应。将表面肝素涂层处理的后房型人工晶状体植入囊袋内 ,可阻滞人工晶状体表面纤维机化膜及后发障形成
Objective To analyze the clinical effect of cataract extraction combined with posterior chamber intraocular lens implantation in diabetic patients. Methods 59 cases (59 eyes) of diabetic patients with cataract extraction combined with posterior chamber intraocular lens implantation were performed from 1992 to 2001. A total of 59 cases (59 eyes) of non-diabetic patients with cataract extraction Combined posterior chamber intraocular lens implantation as a control, both groups were implanted heparin surface treatment of posterior chamber intraocular lens. All cases were using conventional ECCE surgery. Results In the diabetic group, there were 19 cases of corneal edema, 10 cases of exudation, 14 cases of posterior pupil adhesion, 27 cases of posterior capsule opacity and 8 cases of macular degeneration. The diabetic group and non-diabetic postoperative corrected visual acuity no significant difference. Conclusion Although IOL is no longer contraindicated in patients with diabetes mellitus, the fasting blood glucose should be controlled between 5.1 and 8.0 mmol / L before and after surgery. Intraoperative minimize the number of instruments in the anterior chamber operation, reduce damage to the corneal endothelium and iris. The residual lens cortex and viscoelastic flushing clean to reduce the postoperative inflammatory response. Implantation of heparin-coated posterior chamber intraocular lens implantation in the capsular bag can retard the formation of posterior fibrosis and subsequent fibrosis of the intraocular lens