方法：选取2010-01/12在我科行白内障超声乳化吸除术联合人工晶状体植入术的2型糖尿病白内障患者40例62眼为试验组和单纯老年性白内障患者60例82眼为对照组，比较两组术后1d； 1wk； 1，3，6mo的视力及两组术前、术后1d； 1wk； 1，3，6mo的角膜中央厚度的测量和角膜内皮细胞计数。3，6mo时两组散瞳查眼底，试验组中非糖尿病性视网膜病变(non-diabetic retinopathy，NDR)41眼，糖尿病性视网膜病变(diabetic retinopathy，DR)21眼。

结果：最佳矫正视力：术后1d； 1wk； 1mo两组比较，有统计学差异(P<0.05)； 术后3mo，NDR与对照组之间无统计学差异(P>0.05)； NDR与DR、DR与对照组比较，有统计学差异(P<0.05)。术后6mo，NDR与DR、NDR与对照组之间无统计学差异(P>0.05)； DR与对照组比较，有统计学差异(P<0.05)。两组患者术后角膜中央厚度：1d； 1wk； 1，3mo两组比较有统计学差异(P<0.05)，6mo两组比较无统计学差异(P>0.05)； 术后第1d； 1wk两组与术前比较有统计学差异(P<0.05)； 术后1，3mo与术前比较：试验组有统计学差异(P<0.05)，对照组无统计学差异(P>0.05)； 术后6mo与术前比较，两组无统计学差异(P>0.05)。角膜内皮细胞计数的变化：术前两组无统计学差异(P>0.05)，术后1d； 1wk； 1，3，6mo两组之间有统计学差异(P<0.05)； 术后1wk； 1，3，6mo与术前比较，两组均有统计学差异(P<0.05)。

结论：糖尿病患者眼在白内障超声乳化吸除术联合人工晶状体植入术后，早期影响视力的主要原因为术后短期的角膜水肿； 后期影响视力的主要原因为已有的糖尿病性视网膜病变。糖尿病患者眼在白内障手术后表现出更重的内皮细胞损害及术后角膜水肿的恢复延迟。

METHODS:Phacoemulsification and IOL implantation were applied to 40 cataract patients(62 eyes)with type II DM(research group)and 60 cataract patients(82 eyes, control group)between January 2010 and December 2010. Visual acuity was measured 1 day, 1 week, 1 month, 3 months and 6 months post-operation. Central corneal thickness and endothelial cells count were examined pre-operation and 1 day, 1 week, 1 month, 3 months and 6 months post-operation. Fundus was examined under pupil dilatation 3 months and 6 months post-operation. In research group, 41 eyes were observed with non-diabetic retinopathy(NDR)and 21 eyes with DR.

RESULTS: Best corrected visual acuity(BCVA): 1 day, 1 week and 1 month post-operation, significant difference was observed between research group and control group(P<0.05). No significant difference was observed 3 months post-operation between NDR group and control group(P>0.05). Significant difference was observed between NDR and DR as well as between DR and control(P<0.05). No significant difference was observed 6 months post-operation between NDR and DR as well as between NDR and control(P>0.05). Significant difference was observed between DR and control(P<0.05). Central corneal thickness: significant differences were observed between 2 groups 1 day, 1 week, 1 month and 3 months post-operation(P<0.05). No significant differences were observed between 2 groups 6 months post-operation(P>0.05). When measured 1 day, 1 week post-operation, both groups have significant differences compared to pre-operation result(P<0.05). One month and 3 month post-operation, significant difference was observed in research group compared to pre-operation data(P<0.05), while there was no significant difference for control group(P>0.05). Six months post-operation, there was no significant difference compared to pre-operation result between 2 groups(P>0.05). Corneal endothelial cells count: No significant difference was observed between 2 groups pre-operation(P>0.05). Significant differences were observed between 2 groups when measured 1 day, 1 week, 1 month, 3 months and 6 months post-operation(P<0.05). Both groups showed significant difference in 1 week, 1 month, 3 months and 6 months compared to pre-operation measurement(P<0.05).

CONCLUSION: For DM patients after Phaco, key incipient influencing factor of VA is transient cornea edema, while chief factor influencing VA in mid-term is concomitant DR. More severe endothelial damage and recovery retardation of corneal edema were observed in cataract patients with DM after Phaco.