方法：连续收集我院300例300眼择期行超声乳化白内障手术的2型糖尿病患者。根据术中及术后抗炎方式的不同，将患者随机分成3组：A组：术后滴用妥布霉素地塞米松滴眼液+普拉洛芬滴眼液1mo； B组：术中前房注射1mg TA，术后滴用左氧氟沙星滴眼液1mo； C组：术中前房注射2mg TA，术后滴用左氧氟沙星滴眼液1mo。术后不同时点观察和比较三组的视力、眼压、角膜内皮细胞密度、前房炎症反应和黄斑中央厚度的变化情况。

结果：所有手术均顺利进行。B，C组患者术后1d； 1wk； 1mo的最佳矫正视力均优于A组(P<0.05)，术后1d； 1wk的前房炎症反应较A组患者轻(P<0.05)； C组术后1d眼压平均值高于A组，差异具有统计学意义(P<0.05)； B和C组术后各时点的最佳矫正视力，前房炎症反应和平均眼压值均无明显差异(P>0.05)。B和C组术前术后黄斑中央厚度无显著变化，A组术后3wk； 1mo的黄斑中心凹厚度较术前增加，差异显著(P<0.05)。三组各时间点角膜内皮细胞密度均无统计学差异。

结论：2型糖尿病患者白内障超声乳化术中前房注射TA可有效控制炎症并减轻黄斑水肿，加速视力恢复，具有良好的安全性和有效性。我们推荐的白内障超声乳化术中前房内注射TA的剂量为1mg。

METHODS: Three hundred patients(300 eyes)with type 2 diabetes who scheduled for cataract surgery were randomly divided into three groups: group A: 0.3% tobramycin/0.1% dexamethasone eye drops and pranoprofen eye drops treatment for 1mo postoperatively; group B: intrachamberal injection of TA 1mg after cataract surgery, and 0.5% levofloxacin eye drops treatment for one month postoperatively; group C: intrachamberal injection of TA 2mg after cataract surgery, and 0.5% levofloxacin eye drops treatment for one month postoperatively. The main measurements included visual acuity, intraocular pressure(IOP), corneal endothelial cell density, anterior chamber inflammation and the thickness of macula of the three groups.

RESULTS: All cataract surgeries were done successfully by a single surgeon. The best corrected vision of group B and C was better than that of group A 1d, 1wk and 1mo postoperatively(P<0.05). The inflammation of anterior chamber of group B and C was milder than that of group A 1d and 1wk postoperatively(P<0.05). The average IOP of group C 1d postoperatively was higher than that of group A(P<0.05). There was no significant difference between group B and group C on the best corrected vision, anterior chamber inflammation and IOP at any time point. No significant change in the macular thickness was found in patients of group B and C before and after cataract surgery, while there was thicker macula in patients of group A 3wk and 1mo postoperatively when comparing with that of the baseline(P<0.05). There was no significant difference among three groups on corneal endothelial cell density at any time point.

CONCLUSION: Intrachamberal TA injection during phacoemulsification can effectively control postoperative inflammation, reduce the macular edema and accelerate the recovery of visual acuity. Intrachamberal TA 1mg has good effect and safety.