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目的探讨小切口超声乳化白内障吸除联合人工晶体植入术对糖尿病患者血-房水屏障功能的影响以及相关因素。方法选取小切口超声乳化白内障吸除联合人工晶体植入术的连续病例为本研究对象。使用激光闪辉细胞计量仪在术前和术后1月内检测DM组和对照组病例平均前房闪辉计数值。结果DM组32眼和对照组15眼在术前1天,术后1、3、7和30天时的平均前房闪辉计数值分别为3.63±3.00和3.27±1.78、29.54±12.75和19.68±8.54、18.12±10.94和12.47±3.95、10.68±6.46和8.37±3.49,以及7.28±3.84和6.36±2.07(光粒子数/毫秒)。影响手术后1天和3天时DM组平均前房平均闪辉计数值改变的独立因素都仅为累计超声乳化时间。结论小切口超声乳化白内障吸除联合人工晶体植入术导致DM眼原先已存在的血-房水屏障破坏迅速加重。尽量减少超声乳化时间有助于DM患者手术引起的血-房水屏障破坏。
Objective To investigate the effect of small incision phacoemulsification combined with intraocular lens implantation on blood-aqueous barrier function in diabetic patients and its related factors. Methods Selected small incision phacoemulsification combined with intraocular lens implantation continuous cases of this study. The average anterior chamber flash count was measured in the DM and control groups using a laser flash cell cytometer within 1 month before and after surgery. Results In 32 eyes of DM group and 15 eyes of control group, the average anterior chamber flashing counts were 1.63 ± 3.00 and 3.27 ± 1.78, 29.54 ± 12.75 and 19.68 ± 1 at preoperative day 1, postoperative 1, 3, 7 and 30 days respectively 8.54, 18.12 ± 10.94 and 12.47 ± 3.95, 10.68 ± 6.46 and 8.37 ± 3.49, and 7.28 ± 3.84 and 6.36 ± 2.07 (number of light particles per millisecond). The independent factors affecting the mean anterior chamber average flicker count change in DM group at 1 day and 3 days after surgery were only cumulative phacoemulsification time. Conclusion The small incision phacoemulsification combined with intraocular lens implantation has led to the rapid exacerbation of the pre-existing blood-aqueous barrier in the DM eye. Minimizing the time of phacoemulsification contributes to the blood-aqueous barrier disruption caused by surgery in DM patients.