The Influence In Diabetes On Before And After Cataract Phacoemulsification In Ocular Surface

AbstractObjective: To observe the influence in diabetes on before and after cataract phacoemulsification in ocular surface.Methods: Eighty eyes of 59 patients underwent phacoemulsification of senile cataract combined with intraocular lens implantation were selected in our hospital from April 2014 to October 2014, according to whether there is a history of diabetes, they were divided into two groups. A group has 29 cases(40 eyes) with more than 3 years history of diabetes and group B has 30 cases(40 eyes) without a history of diabetes. The two groups have no significant difference in mean age, sex ratio and other conditions. Respectively observed and compared before operation, postoperative on first day, 1 week, 2 weeks, 1 month in the dry eye symptoms(questionnaire), corneal fluorescein staining scores, tear break-up time(BUT) and tear secretion test(Schirmer ’s I test), corneal endothelial cells and other indicators, and then these data were processed by statistical analysis.Results: In group A(diabetic group) postoperative in the tear film function compared with preoperative:corneal fluorescein staining on the first day after operation, 1 week compared with preoperative, coloring point obviously increased, the difference was significant(P<0.001), after 2 weeks, 1 month did not return to the level before operation,with statistical difference(P<0.01); compared with preoperative, on 1 day after operation,1 week, 2 weeks,tear break-up time decreased, with a significant difference(P<0.001), and1 month after operation BUT is still far from recovered to the preoperative level, with significant difference(P<0.001); tear secretion after 1 day, 1 week, 2 weeks increased significantly, the difference was significant(P<0.001), and 1 month after operation has not yet recovered to the preoperative level, with significant difference(P<0.001);postoperative dry eye symptoms had no significant change, no statistical difference(P>0.05). Group B(control group) were compared between the results: 1 month after operation BUT returned to the preoperative level, there was no significant difference(P>0.05); corneal fluorescein staining after 1 month returned to the preoperative level, no significant difference(P>0.05); tear secretion after 1 month recovered to the preoperative level, no significant difference(P>0.05); dry eye symptoms,the feeling of foreign body sensation was significantly improved 1 month postoperative than 1 day after surgery,others were no significant changes.The two groups of patients compared with 1 day after operation, 1 week, 2 weeks in the corneal fluorescein staining(score) had no significant difference,and 1 month after, the two groups had significant difference in corneal fluorescein staining(P<0.05); within 2weeks after operation the tear break-up time in two groups was not statistically significant difference, but 1 month after operation these data had statistical difference(P<0.05); 1month after operation in two groups had significant difference in tear secretion test(P<0.05). In endothelial cells, within 2 weeks, there was no statistically significant difference in the number of endothelial cells of two groups,but 1 month after operation,the number of endothelial cells in group A was less than group B, both with statistical difference(P<0.01), the average endothelial cell area of two groups had no significant difference among each stage.In different course of diabetic patients with phacoemulsification, the incidence of the corneal fluorescein staining>2, BUT<5 was increased with the course on first month after operation, the difference was significant(P<0.05). Comparison of different gender, happen to find BUT<5 was higher in women than in men, with statistically significant difference(P<0.05)Conclusion: The influence of phacoemulsification in the ocular surface was more significant in diabetic patients compared with simple cataract patients implies that we should pay more attention to these cases in clinical works.