Clinical observation of different surgical methods in the treatment of diabetic hard nucleus cataract / 中国基层医药

ABSTRACT

Objective To investigate the clinical effect of different surgical methods in the treatment of diabetic patients with hard nuclear cataract.Methods From May 2016 to May 2018,104 patients with diabetic hard core cataract were selected in Hangzhou Dajiangdong Hospital.According to the surgical methods ,53 cases were divided into small incision group and 51 cases in ultrasound group.The small incision group was treated with small incision cataract extraction,and the ultrasound group was treated by phacoemulsification.The changes of visual acuity and intraocular pressure preoperation and postoperative 1 week and 4 weeks were compared between the two groups.The levels of inflammatory factors preoperation and postoperative 3d,and the occurrence of postoperative complications were compared. Results The visual acuity of the small incision group at 1 week[(0.49 ±0.12)] and 4 weeks[(0.67 ±0.16)] after operation was higher than that before operation [(0.14 ±0.05)] ( t＝19.600,P＝0.000,t＝23.018,P＝0.000), and the visual acuity at 4 weeks after operation was higher than that at 1 week after operation ( t ＝6.552, P ＝0.000).The visual acuity of the ultrasound group at 1 week[(0.46 ±0.15)] and 4 weeks[(0.64 ±0.14)] after operation was higher than that before operation [(0.15 ±0.07)]( t＝19.600,P＝0.000,t＝23.018,P＝0.000), and the visual acuity at 4 weeks after surgery was increased compared with that at 1 week after operation (t＝6.329, P＝0.000).The intraocular pressure of the small incision group at 1 week[(29.83 ±2.65) mmHg] and 4 weeks [(15.47 ±3.38)mmHg] after operation was lower than that of the ultrasonic group at 1 week [(35.39 ±3.24)mmHg] and 4 weeks after operation [(21.97 ±2.06)mmHg](t＝9.596,P＝0.000,t＝11.787,P＝0.000).In the small incision group,3d after operation,the serum TNF－α[(52.41 ±6.28) μg／L]],IL－1β[(24.64 ±4.15) μg／L] and IL－6 [(34.12 ±5.32) μg／L] levels were lower than those in the ultrasound group[TNF－α(78.93 ±10.42)μg／L, IL－1β(38.92 ±4.86)μg／L and IL－6 (56.39 ±7.19)μg／L] (t＝15.789,P＝0.000,t＝16.135,P＝0.000,t＝18.003,P＝0.000).The incidence rate of postoperative complications in the small incision group [13.21%(7／53)] was lower than that in the ultrasound group [39.22%(20／51)] (χ2 ＝9.146,P＝0.000).Conclusion The effect of small incision cataract extraction in the treatment of patients with diabetic hard nuclear cataract is better than phacoe －mulsification,and it causes small inflammatory reaction and less complications.It is worthy of clinical reference.