Incidence And Risk Factors Of Macular Edeme After Cataract Surgery In Diabetic Patients

Objective: To study the macular edema after cataract surgery in patients with type-2 diabetes and the related risk factors.Methods: Select 77 cases(77 eyes)of diabetic patients who performed single-eye cataract ultrasound emulsification surgery in our hospital between June 2018 and June 2019,count the age of patients,ask patients in detail about their diabetes history and insulin use,high blood pressure classification and control,whether there are coronary heart disease,cerebral infarction and other systemic diseases.Preoperative measurement of fasting blood-glucose,(FBG),glycosylated hemoglobin,(Hb A1c),blood pressure(BP),blood lipids,protein urination,creatine(CR),uric acid(UA),lowdensity lipoprotein(LDL),high-density lipoprotein(HDL),total cholesterol(CHO)and graded retinopathy of diabetic at the bottom of the eye.Preoperative,1 day,1 week,January and March,respectively,double-eye optical coherent tomography(Octagraphy,OCTA)examination to measure the patient’s macular center concave retina lourd thickness(Macular)Foveal retina thicknessl FT,determined to occur macular edema by 30% of the postoperative central concave retina thickness greater than the preoperative baseline.According to the results,77 eyes were divided into macular edema group and non-macular edema group,and the differences of influencing factors between the two groups were compared.Results: 77 patients with diabetes completed follow-up,77 surgical eyes 23 eyes had macular edema,54 eyes did not have obvious macular edema,the incidence rate was 29.9%(23/77),77 unoperated eyes(0/77)without obvious macular edema.The incidence rate is 0%.1.The differences between the macular edema group and the non-macular edema group were statistically significant.2,of which 46 cases(46 eyes)were in patients without diabetic retinopathy,5 cases(5 eyes)were caused by macular edema,and 18 cases(18)were in patients with mild and moderate non-value-added diabetic retinopathy(light,moderate NPDR)8 cases(8 eyes)with macular edema,13 cases(13 eyes)in patients with severe non-value-added diabetic retinopathy(severe NPDR),and 10 cases(10 eyes)with macular edema,It was concluded that the incidence of macular edema in patients with diabetic retinopathy was significantly higher than in patients with out-of-diabetes retinopathy,with a statistically significant difference(P=0.000),and the incidence of macular edema in patients with mild moderate NPDR and severe NPDR was higher than in patients without DR(P=0.005,P=0.001),However,there was no statistical difference in the incidence of macular edema between patients with mild moderate and severe NPDR(P=0.139>0.05)3,the age of the patients between the macular edema group and the non-occurring macular edema group(P=0.329),sex(P=0.734),history of hypertension(P=0.215),history of coronary heart disease(P=0.609),history of insulin use(P=0.262)and course of diabetes(P=0.785)No statistical difference.4,there were no statistical differences in biochemical indicators of patients between the macular edema group and the non-occurring macular edema group such as fasting blood-glucose(P=0.393),blood lipids(P=0.411),protein uric(P=0.744),uric acid(P=0.441),low-density lipoprotein(P=0.092),high-density lipoprotein(P=0.798)and total cholesterol(P=0.127).Conclusion: 1,diabetics after the operation of cataract ultrasound emulsification,the incidence of macular edema in the surgical eye is significantly higher than the opposite side nonsurgical eye,indicating that surgery can increase the incidence of macular edema in diabetic patients.2.There was a significant correlation between the incidence of DME and whether the co-enjugate of the retinal lesions in diabetic patients was significantly higher than that of patients without diabetic retinopathy,but there was no significant consistency with the degree of classification of retinopathy.3,the results of multi-factor dual logistic regression analysis showed that diabetic retinopathy,preoperative high glycogenandin and serum creatinine levels are independent risk factors for the occurrence of macular edema after surgery.