Relationship between preoperative glycosylated hemoglobin level and changes in structure and function of macular area in type 2 diabetes mellitus patients after phacoemulsification / 中国医师进修杂志

ABSTRACT

Objective:To explore the relationship between preoperative level of glycosylated hemoglobin (HbA 1c) and changes in structure and function of macular area in patients with type 2 diabetes mellitus (T2DM) after phacoemulsification. Methods:A total of 118 patients with T2DM and monocular cataract undergoing phacoemulsification in Hefei First People′s Hospital, were enrolled between January 2018 and June 2021. According to preoperative HbA 1c level, they were divided into high HbA 1c group (HbA 1c >7.0%, 55 cases) and normal HbA 1c group (HbA 1c ≤7.0%, 63 cases). The central macular thickness (CST), central volume (CV), subfoveal choroidal thickness (SFCT) and incidence of postoperative cystoid macular edema (PCME) between the two groups were compared. The risk factors of PCME were analyzed. Results:At 1 week, 1 month and 3 months after phacoemulsification, CST level in high HbA 1c group was significantly higher than that in normal HbA 1c group (256.21±19.27) μm vs. (242.33 ± 14.63) μm, (277.41 ± 16.39) μm vs. (248.12 ± 11.54) μm, (242.51 ± 11.52) μm vs. (234.87 ± 9.34) μm, and there was statistical difference ( P<0.05). At 3 months after phacoemulsification, CV level in high HbA 1c group was significantly higher than that in normal HbA 1c group (10.40 ± 0.51) mm 2 vs. (10.17 ± 0.47) mm 2 ( P<0.05). The incidence of PCME in high HbA 1c group was significantly higher than that in normal HbA 1c group 25.45% (14/55) vs. 7.94% (5/63) ( P<0.05). Preoperative HbA 1c>7.0% and retinopathy were independent risk factors of PCME ( P<0.05). Conclusions:The preoperative HbA 1c level will affect retina and choroid structures in macular area of patients with T2DM and cataract after phacoemulsification. The risk of PCME is higher in patients with preoperative HbA 1c>7.0%.