The Long-term Study Of The Condition Of The Macular Edema For The Diabetic Patients Undergoing Cataract Surgery

Object:The purpose of this study is to discuss the occurrence of macular edema and the improvement of the visual acuity for the diabetic patients who have been through phacoemulcification 6 months before. Also, to analysis the level of hemoglobin Alc and the use of insulin and other factors possibly related to the macular edema. The study aims to provide a reference to the control of the macular edema after cataract surgery and the timing to intervene.Methods:This study was done in the second affiliated hospital of Zhejiang University School of Medicine. The objective population have taken phacoemulcification between March, 2015 and September 2015, including 29 diabetic patients (39eyes) and 31 non-diabetic patients (39 eyes). The patients were called back to reevaluate the condition of the eyes at six months after the surgery. The patients were examined by optical coherence tomography (OCT) to measure the thick of central fovea of macular, tested best corrected visual acuity(BCVA) and taken blood to test the concentration of the hemoglobin Alc. Then the study analyze the data with the SPSS19.0 statistical software.Result:The study includes 29 diabetic patients(39 eyes) and non-diabetic patients(39 eyes). The age (T=0.187,P=0.852>0.05),gender(χ2=0.217,P=0.642>0.05);hypertension (χ2=0.473,P=0.492>0.05) between two group have no statistical differences. The BCVA (Z=-0.522,P=0.601>0.05)of the patients 6 months after the surgery have no statistical differences;The thick of the central fovea of macular before surgery (T=1.132,P=0.261>0.05)、the thick of the central fovea of macular after six months (T=0.022,P=0.982>0.05) between two group have no statistical differences. The BCVA of the diabetic group before surgery and six-months after surgery (Z=-4.997,P=0.000<0.05) have significant statistical differences. The BCVA of the non-diabetic group before surgery and six-months after surgery (Z=-5.304,P=0.000<0.05)have significant statistical differences;The thick of the central fovea of macular of the diabetic group have significant statistical differences (T=2.184,P=0.035<0.05)before and 6-months after surgery; The thick of the central fovea of macular of the non-diabetic group have significant statistical differences (T=4.368,P=0.000<0.05)before and 6-months after surgery. The incidence rate of the macular edema between diabetic group and non-diabetic group (χ2=4.216,P=0.040<0.05) have significant statistical differences,and the diabetic group significantly higher than the non-diabetic group. The difference of the BCVA before and 6-months after the cataract surgery have correlation with the macular edema (rs=0.227, P=0.045<0.05). The years of diabetes, the hemoglobin Alc, the glucose before surgery, the dependence of insulin have no statistical relation with macular edema and the difference of the BCVA.Conclusion:The incidence rate of the macular edema of the diabetic patients six-months after the phacoemulcification is higher than the non-diabetic patients. The recovery of the BCVA will be influenced if the diabetic patients have macular edema. Both the diabetic and non-diabetic patients improved the BCVA six-months after the cataract surgeries, and the central fovea of macular would be thicker after six months. However, the central fovea of macular did not thicken more than 30% in non-diabetic patients and have no clinical sense.