| Objectives The study was aimed at the exploration of the prevention effect of nonsteroid anti-inflammatory drug diclofenac sodium eye drops for the macular oedema of cataract patients with diabetic mellitus after surgery and the influence on the macular foveal thickness of cataract patients with diabetic mellitus after surgery.Methods A total of 170 cases(206 eyes)of diabetic cataract patients undergoing cataract surgery in hospital during 2015.10-2017.10 months were selected,It is randomly divided into two groups,in the control group,there were 92 cases(110 eyes),including 49 male patients,43 female patients,74 eyes with single eye cataract and 18 cases with binocular cataract.In the study group,there were 78 patients(96 eyes),including 42 male patients,36 female patients,60 eyes with single eye cataract and 18 cases with binocular cataract.All patients were treated with cataract phacoemulsification and intraocular lens implantation.The patients in the control group were given placebo sodium hyaluronate solution for 3 h,2 h,1 h and 0.5 h before operation,1 drops / times,4 weeks after the operation,and 4 times of /d and Tobramycin and Dexamethasone Ophthalmic Suspension 4 times a week for 4 consecutive weeks.The first week drop 6 times/d,second week drop 4 /d,third week drop 2 /d,four week drops 1 /d.The study group in the preoperative 3 h,2 h,1 h and 0.5 h treated with diclofenac sodium eye drops,1 dropped per time,postoperative combined with diclofenac sodium eye drops and Tobramycin and Dexamethasone Ophthalmic Suspension continuous anti infection treatment,diclofenac sodium eye drops for 4 weeks,4 times /d,Tobramycin and Dexamethasone Ophthalmic Suspension was the same as control group.After 4 weeks of intervention,the curative effect was evaluated:(1)The general information of 2 groups were statisticed and compared,which included gender,year,eyes position body mass index(BMI),average BCVA,eyesight,Emery nuclear hardness classification,phacoemulsification parameter tor-tional time(TT),averagetortional amptitude(ATA),effectivephacoemulsificationtime(EPT)and so on;(2)The best corrected visual acuity(BCVA)distribution and the mean BCVA change of 2 groups before surgery and 1 week,1month,3 months after surgery were detected;(3)The changes of macular foveal thickness and macular body volume of 2 groups before surgery and 1 week,1month,3 months after surgery were detected by opticalcoherencetomography;(4)The occurrence of macular oedema of 2 groups patients after surgery were judged and compared according to the macular foveal thickness detected by opticalcoherencetomography and refered to the 《 Clinically meaningful macular hyaluria》featured by 1985 National Diabetes Mellitus Visible Membrane Disease Treatment Study Group;Results There was no significant difference of the main basic materials of gender,year,eyes position,BMI,average BCVA,eyesight,Emery nuclear hardness classification,phacoemulsification parameter TT,ATA,EPT between 2 groups(P>0.05),2 groups had significant feasibility,and could conduct the followed-up comparative study.There was no significant difference of the affected eyes proportion of BCVA<0.1,0.1-0.4,0.5-0.9 and ≥1.0 between 2 groups before surgery(P>0.05).by contrast,the affected eyes proportion of BCVA showed significantly difference between the 2 groups in 1 week 1 month and 3 months after surgery(P<0.05);Compared with before surgery,the mean BCVA in 2 groups increased gradually from 1 week to 1 month after surgery(P<0.01);compared with 1 month after surgery,the mean BCVA in 2 groups 3 months after surgery decreased,but there was no significant difference(P>0.05),and the mean BCVA in study group 1 week,1 month and 3 months after surgery were higher than that in control group(P<0.01).There was no significant difference of the macular foveal thickness and macular body volume between 2 groups before surgery(P>0.05);Compared with before surgery,the macular foveal thickness and macular body volume increased significantly(P<0.05 or P<0.01);compared with 1 week after surgery,the macular foveal thickness and macular body volume increased significantly(P<0.01),while which in study group had no significant changes(P>0.05);the macular foveal thickness and macular body volume in 2 groups decreased 3 months after surgery decreased comprared with 1 month after surgery,but there was no significant difference(P>0.05);the macular foveal thickness and macular body volume in study group 1 week,1 month and 3 months after surgery were lower than those in control group(P<0.01).The macular foveal thickness in 2 groups before surgery were in normal range,and 2 groups had no macular oedema patients.The occurrence rate of macular oedema in 2 groups increased and then decreased from 1 week to 3 months after surgery(P<0.05),and reached the peak at 1 month after surgery;the occurrence rate of macular oedema in study group 1 week,1 month and 3 months after surgery were lower than control group(P<0.05 or P<0.01).Conclusions The non-steroid anti-inflammatory drug diclofenac sodium eye drops adjuvant therapy for cataract patients with diabetic mellitus after surgery before and after surgery can inhibit the local inflammatory response of affected eyes,prevent macular foveal thickness dilapidated,the macular body volume increased seriously,and prevent the occurrence of postoperative macular oedema,and improve the postoperative BCVA,promote the vision recovery. |
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