Abstrato

Prognosis of cataract with diabetic retinopathy by vitrectomy combined with phacoemulsification and its influence on serum related factors

Juan Li, Ning Li, Ziqing Gao

Objective: To evaluate the clinical efficacy of vitrectomy combined with phacoemulsification in the treatment of cataract with diabetic retinopathy (CDR) and to explore its effect on serum inflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and hypersensitive C-reactive protein (hs-CRP) and oxidative stress, including Superoxide dismutase (SOD) and Malondialdehyde (MDA) levels.

Methods: One hundred patients (104 eyes) with CDR were randomly divided into control group and study group (n=50) (52 eyes). The patients in control group were treated by vitrectomy combined with lensectomy, while the patients in study group were treated by Vitrectomy and phacoemulsification. The curative effects of the two groups were observed and the levels of serum inflammatory cytokines (TNF-α, IL-6 and hs-CRP) and oxidative stress (SOD and MDA) levels were compared before and after operation at the same time.

Results: The average visual acuity of the control group and the study group were both significantly improved (P<0.05), and the number of postoperative visual acuity improved eyes and visual acuity overall average in study group patients was significantly greater than the control group (P<0.05). There was no significant difference in serum inflammatory cytokines (TNF-α, IL-6 and hs-CRP) and oxidative stress (SOD and MDA) level between the two groups before operation (P>0.05). The levels of TNF-α, IL-6, hs-CRP and MDA in the study group were significantly lower than those in the control group one month after operation (P<0.05), while the SOD level in the study group was significantly higher than that in the control group (P<0.05). The incidence of iris neovascularization (INV) in the study group was 1.9%, significantly lower than that in the control group (9.6%, P<0.05). The incidence of capsular opacification was 7.7% in the study group, which was significantly lower than that in the control group (28.8%) (P<0.05). Other complications in both groups were recovered after symptomatic treatment.

Conclusion: Compared with vitrectomy and lensectomy, vitrectomy combined with phacoemulsification in the treatment of CDR is more effective in improving postoperative visual acuity, while postoperative complications and incidence of INV is lower, which is worth to be popularized clinically.