目的：观察康柏西普治疗糖尿病患者白内障术后不同类型黄斑水肿的疗效。

方法：选取2017-01/2018-12于我院行白内障超声乳化联合人工晶状体植入术后视力再次下降并确诊为黄斑水肿的糖尿病患者52例52眼。根据黄斑水肿OCT分型，将发生弥漫性黄斑水肿者18眼纳入DRT组，发生黄斑囊样水肿者20眼纳入CME组，发生浆液性视网膜脱离者14眼纳入SRD组，均按照1+PRN方案行玻璃体腔注射康柏西普。治疗(首次玻璃体腔注射)后随访12mo，观察并比较各组患者最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CMT)，并记录药物注射次数。

结果：三组患者治疗前BCVA和CMT无明显差异，但DRT组黄斑水肿发病时间明显短于CME组和SRD组(P<0.05)。治疗后1mo，三组患者BCVA和CMT均明显好转，且治疗后3mo起，三组患者BCVA和CMT继续好转并逐渐稳定，与治疗前比较均明显改善(P<0.05)。治疗后1、3、6、12mo，DRT组和CME组患者BCVA和CMT均好于SRD组(P<0.05)，但DRT组与CME组之间无明显差异(均P>0.05)。三组患者药物注射次数分别为3.2±0.9、2.9±0.8、4.1±1.1次，SRD组注射次数明显多于DRT组和CME组(均P<0.05)。

结论：糖尿病患者白内障术后黄斑水肿应早期干预，康柏西普可以有效改善白内障术后不同类型黄斑水肿患者的视力，减轻黄斑水肿。

METHODS: Totally 52 cases(52 eyes)of macular edema(ME)patients after cataract surgery with diabetes were selected between Jan 2017 and Dec 2018. According to the morphologies of ME through optical coherence tomography(OCT), patients were divided into 3 groups, diffuse retinal thickening(DRT group)with 18 cases(18 eyes), cystoid macular edema(CME group)with 20 cases(20 eyes)and serous retinal detachment(SRD group)with 14 cases(14 eyes). All the patients received intravitreal injection of Conbercept by using 1+PRN method and followed up for 12mo after treatment. The best corrected visual acuity(BCVA)and central macular thickness(CMT)and injection times were recorded and compared.

RESULTS: Before treatment, the differences of BCVA and CMT among 3 groups were not statistically significant, while the course of ME in DRT group was shorter than CME group and SRD group(P<0.05). 1mo after treatment, the BCVA and CMT in 3 groups were improved significant, and beginning at 3mo, the BCVA and CMT in 3 groups were continue to improve and stabilize, they were improved significant compared with before treatment(P<0.05). 1mo, 3mo, 6mo and 12mo after treatment, the BCVA and CMT in DRT group and CME group is better than SRD group(P<0.05), while the BCVA and CMT among DRT group and CME group were not statistically significant(P>0.05). The injection times in 3 groups was 3.2±0.9, 2.9±0.8 and 4.1±1.1, the injection times in SRD group was the most frequent in 3 groups(P<0.05).

CONCLUSION: ME after cataract surgery with diabetes should be treated early. Conbercept could improve BCVA and CMT in different types of ME after cataract surgery with diabetes effectively.