Визуальные исходы факоэмульсификации катаракты у пациентов с сахарным диабетом и различной клинической рефракцией

Abstract

Purpose. To study the results of phacoemulsification (PE) in patients with diabetes mellitus (DM) depending on the anterior-posterior axis (APA) and eye refraction. Material and methods. The study involved 57 patients (57 eyes) with insulin-dependent compensated or subcompensated DM (type II). All the patients underwent PE with IOL implantation. According to the nature of refraction, the patients were divided into 3 groups: group 1 — 16 patients (16 eyes) with moderate and high myopia, group 2 — 18 people (18 eyes) with hypermetropia, group 3 — 23 patients (23 eyes) with emmetropia. Distribution of the patients according to the length of the anterior-posterior axis (APA): with moderate myopia and APA from 25.01 to 26.5 mm (7), high myopia and APA above 26.51 mm (9), with emmetropia and APA from 22.2 to 23.8 mm (23) and APA less than 22.2 mm — hypermetropics (18). Results. VA in the early and late postoperative period in patients with DM and myopic refraction after PE was higher than in patients with hypermetropia and emmetropia. Visual acuity of 0.5 and higher was observed at discharge in 75.0 % of patients with myopia (and changes in the retina in the form of diabetic retinopathy were much less frequent) than in patients with hypermetropia (50.0 %) and emmetropia (52.2 %), and in long-term follow-up in 73.3 %, 37.5 % and 36.8 %, respectively. Destabilization of diabetic retinopathy with the transition to the next stage was observed twice less often in patients with myopia (13.3 %) than in patients with hypermetropia and emmetropia (25 % and 26.3 %, respectively). Conclusion. Visual outcomes after cataract surgery in diabetic patients are strongly affected by refraction and the axial length of the eyeball. At discharge visual acuity of 0.5 and higher was observed in 75.0 % of myopic patients, 50.0 % of hypermetropics and 52.2 % of emmetropic patients; and over 3 years of follow-up — in 73.3 %, 37.5 % and 36.8 % respectively. At hospital discharge diabetic retinopathy in myopic patients was observed 4.3 times less frequently than in patients with emmetropia and hypermetropia, and its destabilization with the transition to the next stage after 3 years of postoperative follow-up was twice less often: in 13.3 % vs. 25 % and 26.3 %, respectively. Keywords: diabetes mellitus, cataract, phacoemulsification, anterior-posterior axis of the eye, refraction, myopia, visual acuity, diabetic retinopathy