糖尿病白内障术后并发症和手术时机选择_West China Medical Journal

Authors：

谭舟利 ,  范玮

四川大学华西医院眼科（成都 610041）;

Corresponding author：

范玮, Email: fanwei55@yahoo.com

Keywords：

糖尿病; 白内障; 并发症; 人工晶状体; 黄斑水肿

DOI：

10.7507/1002-0179.201603279

Video：

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随着我国糖尿病患病率的增加，需行白内障手术的糖尿病患者也逐渐增多，糖尿病患者行白内障手术的各类并发症的发生率高于非糖尿病患者，影响术后视力。常见并发症包括黄斑囊样水肿、角膜相关并发症、囊袋收缩和后囊混浊。影响手术时机选择的主要因素包括血糖水平、围手术期的视网膜激光光凝术及玻璃体切除术。此外，糖尿病患者白内障手术时人工晶状体的选择需要特别考虑。该文综述了糖尿病患者白内障术后黄斑水肿的最新研究进展、角膜相关并发症以及囊袋相关并发症，同时简述了该类患者手术时机选择的影响因素以及人工晶状体的选择。

Citation： 谭舟利, 范玮. 糖尿病白内障术后并发症和手术时机选择. West China Medical Journal, 2017, 32(4): 612-617. doi: 10.7507/1002-0179.201603279 Copy

1.	Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol, 2012, 96(5): 614-618.
2.	中华医学会糖尿病学分会. 中国 2 型糖尿病防治指南 (2013 年版). 中国医学前沿杂志:电子版, 2015(3): 26-89.
3.	中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南 (2014 年). 中华眼科杂志, 2014, 50(11): 851-865.
4.	Hashim Zehra, Zarina Shamshad. Advanced glycation end products in diabetic and non-diabetic human subjects suffering from cataract. Age (Dordr), 2011, 33(3): 377-384.
5.	Ostri Christoffer, Lux Anja, Lund-Andersen Henrik,et al. Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy: a 10-year follow-up study. Acta Ophthalmol, 2014, 92(6): 571-576.
6.	Gillies C, Islam M, Larsson Jörgen,et al. Triamcinolone-induced cataract in eyes with diabetic macular oedema: 3-year prospective data from a randomized clinical trial. Clin Experiment Ophthalmol, 2010, 38(6): 605-612.
7.	Chiseliţă Dorin, Huţuleac Alexandra, Cantemir Alina,et al. Long-term course of visual acuity in patients with cataract surgery. Oftalmologia, 2012, 56(2): 56-62.
8.	Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol, 1985, 103(12): 1796-1806.
9.	Kim J, Equi Robert, Bressler M. Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology, 2007, 114(5): 881-889.
10.	Trichonas George, Kaiser K. Optical coherence tomography imaging of macular oedema. Br J Ophthalmol, 2014, 98(Suppl 2): ii24-ii29.
11.	杨晓璐, 邹海东, 许迅. 不同类型糖尿病黄斑水肿患者视网膜敏感度和视力与黄斑厚度相关性分析. 中华眼科杂志, 2013, 49(12): 1081-1088.
12.	Hong Thomas, Mitchell Paul, de Loryn Tania,et al. Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery. Ophthalmology, 2009, 116(8): 1510-1514.
13.	Wahab S, Faiz-ur-Rab K, Das Hargun L. Early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema. J Coll Physicians Surg Pak, 2013, 23(6): 401-404.
14.	Katsimpris M, Petropoulos K, Zoukas G,et al. Central foveal thickness before and after cataract surgery in normal and in diabetic patients without retinopathy. Klin Monbl Augenheilkd, 2012, 229(4): 331-337.
15.	Terada Yukiko, Masuda Ayami, Nejima Ryohei,et al. The anti-inflammatory effect of 0.1% bromfenac and 0.1% betamethasone combination in post-cataract surgery patients with diabetes mellitus. Nihon Ganka Gakkai Zasshi, 2014, 118(8): 645-651.
16.	Brito N, Rosas M, Coentrão M,et al. Evaluation of visual acuity, macular status, and subfoveal choroidal thickness changes after cataract surgery in eyes with diabetic retinopathy. Retina, 2015, 35(2): 294-302.
17.	Patel I, Hykin G, Cree A. Diabetic cataract removal: postoperative progression of maculopathy--growth factor and clinical analysis. Br J Ophthalmol, 2006, 90(6): 697-701.
18.	Dong Ning, Xu Bing, Wang Bingsong,et al. Aqueous cytokines as predictors of macular edema in patients with diabetes following uncomplicated phacoemulsification cataract surgery. Biomed Res Int, 2015(126984): 126984.
19.	Campos António, Beselga Diana, Mendes Sílvia,et al. Deferred intravitreal triamcinolone in diabetic eyes after phacoemulsification. J Ocul Pharmacol Ther, 2014, 30(9): 717-728.
20.	Lam S, Chan K, Mohamed S,et al. Phacoemulsification with intravitreal triamcinolone in patients with cataract and coexisting diabetic macular oedema: a 6-month prospective pilot study. Eye (Lond), 2005, 19(8): 885-890.
21.	Shimura Masahiko, Nakazawa Toru, Yasuda Kanako,et al. Diclofenac prevents an early event of macular thickening after cataract surgery in patients with diabetes. J Ocul Pharmacol Ther, 2007, 23(3): 284-291.
22.	Fard MA, Yazdanei Abyane A, Malihi M. Prophylactic intravitreal bevacizumab for diabetic macular edema (thickening) after cataract surgery: prospective randomized study. Eur J Ophthalmol, 2011, 21(3): 276-281.
23.	Wahab S, Ahmed J. Management of cataract with macular oedema due to diabetes mellitus type-II and hypertension with grid laser prior to surgery and intra-vitreal bevacizumab (Avastin) peroperatively. J Pak Med Assoc, 2010, 60(10): 836-839.
24.	Ilhan Ozgür, Ilhan Nilüfer, Coşkun Mesut,et al. The effect of enoxaparin-containing irrigation fluid used during cataract surgery on postoperative inflammation in patients with diabetes. Am J Ophthalmol, 2013, 156(6): 1120-1124.e3.
25.	Maedel Sophie, Hirnschall Nino, Chen An,et al. Effect of heparin coating of a foldable intraocular lens on inflammation and capsular bag performance after cataract surgery. J Cataract Refract Surg, 2013, 39(12): 1810-1817.
26.	Shakya K, Pokharel S, Karki J,et al. Corneal edema after phacoemulsification surgery in patients with type Ⅱ diabetes mellitus. Nepal J Ophthalmol, 2013, 5(2): 230-234.
27.	Misra L, Goh Wei, Patel V,et al. Corneal microstructural changes in nerve fiber, endothelial and epithelial density after cataract surgery in patients with diabetes mellitus. Cornea, 2015, 34(2): 177-181.
28.	Yang R, Sha X, Zeng M,et al. The influence of phacoemulsification on corneal endothelial cells at varying blood glucose levels. Eye Sci, 2011, 26(2): 91-95.
29.	Hugod M, Storr-Paulsen A, Norregaard JC,et al. Corneal endothelial cell changes associated with cataract surgery in patients with type 2 diabetes mellitus. Cornea, 2011, 30(7): 749-753.
30.	Gujar P, Bhasin P, Bhasin P. Bilateral descemet’s membrane detachment after uneventful phacoemulsification in a case of diabetes mellitus. Indian J Ophthalmol, 2012, 61(1): 28-29.
31.	Abdelkader H, Patel V, Mcghee Nj,et al. New therapeutic approaches in the treatment of diabetic keratopathy: a review. Clin Experiment Ophthalmol, 2011, 39(3): 259-270.
32.	Messmer M, Schmid-Tannwald C, Zapp D,et al.In vivo confocal microscopy of corneal small fiber damage in diabetes mellitus. Graefes Arch Clin Exp Ophthalmol, 2010, 248(9): 1307-1312.
33.	Kallinikos P, Berhanu M, O’donnell C,et al. Corneal nerve tortuosity in diabetic patients with neuropathy. Invest Ophthalmol Vis Sci, 2004, 45(2): 418-422.
34.	Erie JC, Mclaren JW, Hodge DO,et al. Recovery of corneal subbasal nerve density after PRK and LASIK. Am J Ophthalmol, 2005, 140(6): 1059-1064.
35.	Lee BH, Mclaren JW, Erie JC,et al. Reinnervation in the cornea after LASIK. Invest Ophthalmol Vis Sci, 2002, 43(12): 3660-3664.
36.	Takamura Y, Tomomatsu T, Arimura S,et al. Anterior capsule contraction and flare intensity in the early stages after cataract surgery in eyes with diabetic retinopathy. J Cataract Refract Surg, 2013, 39(5): 716-721.
37.	Zarnowski T, Machowicz-Matejko E, Zagórski Z. Anterior chamber inflammation following cataract surgery in patients with non-insulin-dependent diabetes mellitus. Klin Oczna, 2002, 104(5/6): 354-356.
38.	Yang Y, Zhang J, Yan H. Comparison of combined and sequential surgery for proliferative diabetic retinopathy: a single surgeon study. PLoS One, 2014, 9(9): e108933.
39.	Hayashi H, Hayashi K, Nakao F,et al. Area reduction in the anterior capsule opening in eyes of diabetes mellitus patients. J Cataract Refract Surg, 1998, 24(8): 1105-1110.
40.	Kato S, Oshika T, Numaga J,et al. Anterior capsular contraction after cataract surgery in eyes of diabetic patients. Br J Ophthalmol, 2001, 85(1): 21-23.
41.	Kim C, Hwang S, Kim S. Anterior capsular phimosis occluding the capsulorhexis opening after cataract surgery in a diabetic patient with high hemoglobin A1C. Semin Ophthalmol, 2013, 28(2): 68-71.
42.	Elgohary A, Dowler G. Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non-diabetic and diabetic patients. Clin Experiment Ophthalmol, 2006, 34(6): 526-534.
43.	Praveen R, Vasavada R, Shah D,et al. A prospective evaluation of posterior capsule opacification in eyes with diabetes mellitus: a case-control study. Eye (Lond), 2014, 28(6): 720-727.
44.	Mozaffarieh M, Heinzl H, Sacu S,et al. Second eye cataract surgery in the diabetes patient? Quality of life gains and speed of visual and functional rehabilitation. Ophthalmic Res, 2009, 41(1): 2-8.
45.	Gabrić N, Henc-Petrinović L, Dekaris I,et al. Timing of cataract surgery in diabetics. Acta Med Croatica, 1996, 50(1): 25-28.
46.	Ilavska M. The impact of phacoemulsification cataract surgery on eyes previously treated by laser photocoagulation for diabetic retinopathy. Bratisl Lek Listy, 2013, 114(3): 145-149.
47.	Suto C, Hori S, Kato S,et al. Effect of perioperative glycemic control in progression of diabetic retinopathy and maculopathy. Arch Ophthalmol, 2006, 124(1): 38-45.
48.	Nascimento A, Lira P, Kara-José N,et al. Predictive value of preoperative fasting glucose test of diabetic patients regarding surgical outcome in cataract surgery. Arq Bras Oftalmol, 2005, 68(2): 213-217.
49.	Suto C, Hori S, Kato S. Management of type 2 diabetics requiring panretinal photocoagulation and cataract surgery. J Cataract Refract Surg, 2008, 34(6): 1001-1006.
50.	Suto C, Kitano S, Hori S. Optimal timing of cataract surgery and panretinal photocoagulation for diabetic retinopathy. Diabetes Care, 2011, 34(7): e123.
51.	Wahab S, Das Hargun L. Combined phacoemulsification, vitrectomy and endolaser photocoagulation in patients with diabetic retinopathy and cataract. J Coll Physicians Surg Pak, 2014, 24(10): 736-739.
52.	Pinarci Y, Bayar A, Sizmaz S,et al. Anterior segment complications after phacovitrectomy in diabetic and nondiabetic patients. Eur J Ophthalmol, 2013, 23(2): 223-229.
53.	Lee Y, Jeong S, Sohn J,et al. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification in patients with proliferative diabetic retinopathy. Retina, 2011, 31(9): 1753-1758.
54.	Rivas-Aguiño P, García-Amaris A, Berrocal H,et al. Pars plana vitrectomy, phacoemulsification and intraocular lens implantation for the management of cataract and proliferative diabetic retinopathy: comparison of a combinedversus two-step surgical approach. Arch Soc Esp Oftalmol, 2009, 84(1): 31-38.
55.	Orczykowska M, Owidzkaz M, Synder A,et al. Comparative analysis of early distance visual acuity in patients after coaxial phacoemulsification through the micro-incision (1.8 mm) and after standard phacoemulsification through the small incision (2.75 mm) Klin Oczna, 2014, 116(1): 7-10.
56.	Rodríguez-Galietero A, Montés-Micó R, Muñoz G,et al. Blue-light filtering intraocular lens in patients with diabetes: contrast sensitivity and chromatic discrimination. J Cataract Refract Surg, 2005, 31(11): 2088-2092.
57.	Lauwers N, Ní Dhubhghaill S, Mathysen G,et al. Assessment of the bag-in-the-lens implantation technique in diabetic patients. Ophthalmologica, 2013, 229(4): 212-218.
58.	王涵, 王皓月. 糖尿病视网膜病变进展的危险因素分析. 华西医学, 2016, 31(5): 889-892.
59.	欧青, 袁丽, 古艳. 个体化糖尿病教育处方对门诊糖尿病患者血糖控制的影响. 华西医学, 2015, 30(9): 1709-1712.

1. Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol, 2012, 96(5): 614-618.
2. 中华医学会糖尿病学分会. 中国 2 型糖尿病防治指南 (2013 年版). 中国医学前沿杂志:电子版, 2015(3): 26-89.
3. 中华医学会眼科学会眼底病学组. 我国糖尿病视网膜病变临床诊疗指南 (2014 年). 中华眼科杂志, 2014, 50(11): 851-865.
4. Hashim Zehra, Zarina Shamshad. Advanced glycation end products in diabetic and non-diabetic human subjects suffering from cataract. Age (Dordr), 2011, 33(3): 377-384.
5. Ostri Christoffer, Lux Anja, Lund-Andersen Henrik,et al. Long-term results, prognostic factors and cataract surgery after diabetic vitrectomy: a 10-year follow-up study. Acta Ophthalmol, 2014, 92(6): 571-576.
6. Gillies C, Islam M, Larsson Jörgen,et al. Triamcinolone-induced cataract in eyes with diabetic macular oedema: 3-year prospective data from a randomized clinical trial. Clin Experiment Ophthalmol, 2010, 38(6): 605-612.
7. Chiseliţă Dorin, Huţuleac Alexandra, Cantemir Alina,et al. Long-term course of visual acuity in patients with cataract surgery. Oftalmologia, 2012, 56(2): 56-62.
8. Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol, 1985, 103(12): 1796-1806.
9. Kim J, Equi Robert, Bressler M. Analysis of macular edema after cataract surgery in patients with diabetes using optical coherence tomography. Ophthalmology, 2007, 114(5): 881-889.
10. Trichonas George, Kaiser K. Optical coherence tomography imaging of macular oedema. Br J Ophthalmol, 2014, 98(Suppl 2): ii24-ii29.
11. 杨晓璐, 邹海东, 许迅. 不同类型糖尿病黄斑水肿患者视网膜敏感度和视力与黄斑厚度相关性分析. 中华眼科杂志, 2013, 49(12): 1081-1088.
12. Hong Thomas, Mitchell Paul, de Loryn Tania,et al. Development and progression of diabetic retinopathy 12 months after phacoemulsification cataract surgery. Ophthalmology, 2009, 116(8): 1510-1514.
13. Wahab S, Faiz-ur-Rab K, Das Hargun L. Early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema. J Coll Physicians Surg Pak, 2013, 23(6): 401-404.
14. Katsimpris M, Petropoulos K, Zoukas G,et al. Central foveal thickness before and after cataract surgery in normal and in diabetic patients without retinopathy. Klin Monbl Augenheilkd, 2012, 229(4): 331-337.
15. Terada Yukiko, Masuda Ayami, Nejima Ryohei,et al. The anti-inflammatory effect of 0.1% bromfenac and 0.1% betamethasone combination in post-cataract surgery patients with diabetes mellitus. Nihon Ganka Gakkai Zasshi, 2014, 118(8): 645-651.
16. Brito N, Rosas M, Coentrão M,et al. Evaluation of visual acuity, macular status, and subfoveal choroidal thickness changes after cataract surgery in eyes with diabetic retinopathy. Retina, 2015, 35(2): 294-302.
17. Patel I, Hykin G, Cree A. Diabetic cataract removal: postoperative progression of maculopathy--growth factor and clinical analysis. Br J Ophthalmol, 2006, 90(6): 697-701.
18. Dong Ning, Xu Bing, Wang Bingsong,et al. Aqueous cytokines as predictors of macular edema in patients with diabetes following uncomplicated phacoemulsification cataract surgery. Biomed Res Int, 2015(126984): 126984.
19. Campos António, Beselga Diana, Mendes Sílvia,et al. Deferred intravitreal triamcinolone in diabetic eyes after phacoemulsification. J Ocul Pharmacol Ther, 2014, 30(9): 717-728.
20. Lam S, Chan K, Mohamed S,et al. Phacoemulsification with intravitreal triamcinolone in patients with cataract and coexisting diabetic macular oedema: a 6-month prospective pilot study. Eye (Lond), 2005, 19(8): 885-890.
21. Shimura Masahiko, Nakazawa Toru, Yasuda Kanako,et al. Diclofenac prevents an early event of macular thickening after cataract surgery in patients with diabetes. J Ocul Pharmacol Ther, 2007, 23(3): 284-291.
22. Fard MA, Yazdanei Abyane A, Malihi M. Prophylactic intravitreal bevacizumab for diabetic macular edema (thickening) after cataract surgery: prospective randomized study. Eur J Ophthalmol, 2011, 21(3): 276-281.
23. Wahab S, Ahmed J. Management of cataract with macular oedema due to diabetes mellitus type-II and hypertension with grid laser prior to surgery and intra-vitreal bevacizumab (Avastin) peroperatively. J Pak Med Assoc, 2010, 60(10): 836-839.
24. Ilhan Ozgür, Ilhan Nilüfer, Coşkun Mesut,et al. The effect of enoxaparin-containing irrigation fluid used during cataract surgery on postoperative inflammation in patients with diabetes. Am J Ophthalmol, 2013, 156(6): 1120-1124.e3.
25. Maedel Sophie, Hirnschall Nino, Chen An,et al. Effect of heparin coating of a foldable intraocular lens on inflammation and capsular bag performance after cataract surgery. J Cataract Refract Surg, 2013, 39(12): 1810-1817.
26. Shakya K, Pokharel S, Karki J,et al. Corneal edema after phacoemulsification surgery in patients with type Ⅱ diabetes mellitus. Nepal J Ophthalmol, 2013, 5(2): 230-234.
27. Misra L, Goh Wei, Patel V,et al. Corneal microstructural changes in nerve fiber, endothelial and epithelial density after cataract surgery in patients with diabetes mellitus. Cornea, 2015, 34(2): 177-181.
28. Yang R, Sha X, Zeng M,et al. The influence of phacoemulsification on corneal endothelial cells at varying blood glucose levels. Eye Sci, 2011, 26(2): 91-95.
29. Hugod M, Storr-Paulsen A, Norregaard JC,et al. Corneal endothelial cell changes associated with cataract surgery in patients with type 2 diabetes mellitus. Cornea, 2011, 30(7): 749-753.
30. Gujar P, Bhasin P, Bhasin P. Bilateral descemet’s membrane detachment after uneventful phacoemulsification in a case of diabetes mellitus. Indian J Ophthalmol, 2012, 61(1): 28-29.
31. Abdelkader H, Patel V, Mcghee Nj,et al. New therapeutic approaches in the treatment of diabetic keratopathy: a review. Clin Experiment Ophthalmol, 2011, 39(3): 259-270.
32. Messmer M, Schmid-Tannwald C, Zapp D,et al.In vivo confocal microscopy of corneal small fiber damage in diabetes mellitus. Graefes Arch Clin Exp Ophthalmol, 2010, 248(9): 1307-1312.
33. Kallinikos P, Berhanu M, O’donnell C,et al. Corneal nerve tortuosity in diabetic patients with neuropathy. Invest Ophthalmol Vis Sci, 2004, 45(2): 418-422.
34. Erie JC, Mclaren JW, Hodge DO,et al. Recovery of corneal subbasal nerve density after PRK and LASIK. Am J Ophthalmol, 2005, 140(6): 1059-1064.
35. Lee BH, Mclaren JW, Erie JC,et al. Reinnervation in the cornea after LASIK. Invest Ophthalmol Vis Sci, 2002, 43(12): 3660-3664.
36. Takamura Y, Tomomatsu T, Arimura S,et al. Anterior capsule contraction and flare intensity in the early stages after cataract surgery in eyes with diabetic retinopathy. J Cataract Refract Surg, 2013, 39(5): 716-721.
37. Zarnowski T, Machowicz-Matejko E, Zagórski Z. Anterior chamber inflammation following cataract surgery in patients with non-insulin-dependent diabetes mellitus. Klin Oczna, 2002, 104(5/6): 354-356.
38. Yang Y, Zhang J, Yan H. Comparison of combined and sequential surgery for proliferative diabetic retinopathy: a single surgeon study. PLoS One, 2014, 9(9): e108933.
39. Hayashi H, Hayashi K, Nakao F,et al. Area reduction in the anterior capsule opening in eyes of diabetes mellitus patients. J Cataract Refract Surg, 1998, 24(8): 1105-1110.
40. Kato S, Oshika T, Numaga J,et al. Anterior capsular contraction after cataract surgery in eyes of diabetic patients. Br J Ophthalmol, 2001, 85(1): 21-23.
41. Kim C, Hwang S, Kim S. Anterior capsular phimosis occluding the capsulorhexis opening after cataract surgery in a diabetic patient with high hemoglobin A1C. Semin Ophthalmol, 2013, 28(2): 68-71.
42. Elgohary A, Dowler G. Incidence and risk factors of Nd:YAG capsulotomy after phacoemulsification in non-diabetic and diabetic patients. Clin Experiment Ophthalmol, 2006, 34(6): 526-534.
43. Praveen R, Vasavada R, Shah D,et al. A prospective evaluation of posterior capsule opacification in eyes with diabetes mellitus: a case-control study. Eye (Lond), 2014, 28(6): 720-727.
44. Mozaffarieh M, Heinzl H, Sacu S,et al. Second eye cataract surgery in the diabetes patient? Quality of life gains and speed of visual and functional rehabilitation. Ophthalmic Res, 2009, 41(1): 2-8.
45. Gabrić N, Henc-Petrinović L, Dekaris I,et al. Timing of cataract surgery in diabetics. Acta Med Croatica, 1996, 50(1): 25-28.
46. Ilavska M. The impact of phacoemulsification cataract surgery on eyes previously treated by laser photocoagulation for diabetic retinopathy. Bratisl Lek Listy, 2013, 114(3): 145-149.
47. Suto C, Hori S, Kato S,et al. Effect of perioperative glycemic control in progression of diabetic retinopathy and maculopathy. Arch Ophthalmol, 2006, 124(1): 38-45.
48. Nascimento A, Lira P, Kara-José N,et al. Predictive value of preoperative fasting glucose test of diabetic patients regarding surgical outcome in cataract surgery. Arq Bras Oftalmol, 2005, 68(2): 213-217.
49. Suto C, Hori S, Kato S. Management of type 2 diabetics requiring panretinal photocoagulation and cataract surgery. J Cataract Refract Surg, 2008, 34(6): 1001-1006.
50. Suto C, Kitano S, Hori S. Optimal timing of cataract surgery and panretinal photocoagulation for diabetic retinopathy. Diabetes Care, 2011, 34(7): e123.
51. Wahab S, Das Hargun L. Combined phacoemulsification, vitrectomy and endolaser photocoagulation in patients with diabetic retinopathy and cataract. J Coll Physicians Surg Pak, 2014, 24(10): 736-739.
52. Pinarci Y, Bayar A, Sizmaz S,et al. Anterior segment complications after phacovitrectomy in diabetic and nondiabetic patients. Eur J Ophthalmol, 2013, 23(2): 223-229.
53. Lee Y, Jeong S, Sohn J,et al. Combined 23-gauge sutureless vitrectomy and clear corneal phacoemulsification in patients with proliferative diabetic retinopathy. Retina, 2011, 31(9): 1753-1758.
54. Rivas-Aguiño P, García-Amaris A, Berrocal H,et al. Pars plana vitrectomy, phacoemulsification and intraocular lens implantation for the management of cataract and proliferative diabetic retinopathy: comparison of a combinedversus two-step surgical approach. Arch Soc Esp Oftalmol, 2009, 84(1): 31-38.
55. Orczykowska M, Owidzkaz M, Synder A,et al. Comparative analysis of early distance visual acuity in patients after coaxial phacoemulsification through the micro-incision (1.8 mm) and after standard phacoemulsification through the small incision (2.75 mm) Klin Oczna, 2014, 116(1): 7-10.
56. Rodríguez-Galietero A, Montés-Micó R, Muñoz G,et al. Blue-light filtering intraocular lens in patients with diabetes: contrast sensitivity and chromatic discrimination. J Cataract Refract Surg, 2005, 31(11): 2088-2092.
57. Lauwers N, Ní Dhubhghaill S, Mathysen G,et al. Assessment of the bag-in-the-lens implantation technique in diabetic patients. Ophthalmologica, 2013, 229(4): 212-218.
58. 王涵, 王皓月. 糖尿病视网膜病变进展的危险因素分析. 华西医学, 2016, 31(5): 889-892.
59. 欧青, 袁丽, 古艳. 个体化糖尿病教育处方对门诊糖尿病患者血糖控制的影响. 华西医学, 2015, 30(9): 1709-1712.

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糖尿病白内障术后并发症和手术时机选择

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