方法：选取2013-01/2015-01在我院眼科行白内障手术的患者121例160眼，分为正常对照组40例50眼和糖尿病组81例110眼，其中糖尿病组分为低HbA1c组(HbA1c≤7.0%)和高HbA1c组(HbA1c>7.0%)。采用光学相干断层扫描仪(OCT)于白内障摘除术前、术后1mo进行黄斑中心凹视网膜厚度、黄斑总容积的检查。分析HbA1c值与黄斑区视网膜厚度的关系。

结果：糖尿病组患者白内障术前、术后1mo黄斑中心凹视网膜厚度与正常组比较差异有统计学意义(P<0.05)，且糖尿病组的厚。低HbA1c组与高HbA1c组术前、术后1mo黄斑中心凹视网膜厚度及黄斑区总容积比较差异均有统计学意义(P<0.05)。低HbA1c组术前、术后1mo黄斑中心凹视网膜厚度均比正常组厚，但差异无统计学意义(P>0.05)。HbA1c与术前黄斑中心凹视网膜厚度(r=0.254，P<0.01)、术前黄斑区容积(r=0.276，P<0.01)、术后黄斑中心凹视网膜厚度(r=0.349，P<0.01)、术后黄斑总容积呈正相关(r=0.286，P<0.01)。

结论：HbA1c与糖尿病患者白内障术后黄斑区视网膜厚度呈正相关。术前HbA1c高于7.0%的白内障患者，应积极随访黄斑区视网膜厚度，及时干预，保护患者视功能。

METHODS: one hundred and twenty one patients(160 eyes)underwent phacoemulsification were divided into normal control group(40 patients with 50 eyes)and diabetic group(81 cases with 110 eyes).The patients in the diabetic group was divided into two subgroups, low HbA1c group(HbA1c≤7.0%)and high HbA1c group(HbA1c>7.0%). All patients underwent optical coherence tomography(OCT)before and 1mo after cataract surgery to check foveal retinal thickness and total macular volume. The relation between HbA1c levels and macular retinal thickness was analyzed.

RESULTS: Foveal retinal thickness before and at 1mo after cataract surgery in patients with diabetes were thicker, compared with normal control group, and the difference was statistically significant(P<0.05). Foveal retinal thickness and total macular volume before and at 1mo after surgery in high HbA1c group were thicker than those in low HbA1c group, and differences were statistically significant(P<0.05). Foveal retinal thickness before and at 1mo after surgery in low HbA1c group was thicker than those in normal control group, but the differences was not statistically significant(P>0.05). HbA1c and preoperative foveal retinal thickness(r=0.254,P<0.01), preoperative total macular volume(r=0.276, P<0.01), postoperative foveal retinal thickness(r=0.349, P<0.01), postoperative total macular volume(r=0.286, P<0.01)were positively correlated.

CONCLUSION: HbA1c and diabetic macular thickness after cataract surgery were positively correlated. If preoperative HbA1c is higher than 7.0% in diabetic patients with cataract, macular thickness should be actively followed up and giuen timely intervention, in order to protect visual function.