作者： Chen SH,Shah AS

　　出处：Current opinion in ophthalmology.2010-01;21(1):4-9.

　　文献类型：综述 PUBMED链接：PMID 19935423

　　Abstract：PURPOSE OF REVIEW:Recent studies have focused on interventions to minimize progression of ... PURPOSE OF REVIEW:Recent studies have focused on interventions to minimize progression of retinal disease in diabetic patients undergoing cataract surgery. Here, we review the evidence for progression of diabetic retinal disease with cataract surgery and critically analyze the interventions proposed to minimize it.

　　RECENT FINDINGS:Peri-operative intravitreal bevacizumab, sub-Tenon's triamcinolone, and panretinal photocoagulation (PRP) after cataract surgery (instead of before) have been examined as ways to improve cataract surgery results in diabetic patients. The bevacizumab and triamcinolone results are promising, but the inclusion criteria are variable, the sample sizes are small, and the follow-up is short. Postsurgery PRP shows improved cataract surgery results in diabetics with more severe retinopathy up to 1 year after surgery.

　　SUMMARY:Recent studies do not support the generalized conclusion that phacoemulsification surgery causes progression of retinopathy and macular edema in all diabetic patients. In certain populations of diabetic patients undergoing cataract surgery, peri-operative triamcinolone and bevacizumab may blunt the progression of diabetic macular edema and diabetic retinopathy. The optimal timing of PRP in relation to cataract surgery in patients with more severe retinopathy warrants further evaluation.

　　中文摘要：

　　综述目的：近来的研究多集中于减轻行白内障手术糖尿病患者视网膜病变的干预措施。在此，我们综述了白内障手术患者糖尿病视网膜病变的相关证据，并对减轻病变的干预措施进行了批判性分析。

　　近期发现：手术期间玻璃体内贝伐单抗注射和眼球筋膜下曲安西龙注射以及术后(而不是术前)全视网膜光凝固术(PRP)可以改善糖尿病患者白内障手术的预后。虽然贝伐单抗和曲安西龙试验的结果较好，但其试验对象的选择标准不同，样本含量均较小且随访时间也较短。对于伴有更严重视网膜病变的糖尿病患者，手术后1年行PRP术仍可以改善患者白内障手术的预后。

　　小结：近期的研究并不能支持如下概括性结论：超声乳化白内障吸除术会加重糖尿病患者的视网膜病变和黄斑水肿。对于行白内障手术的糖尿病人群，手术期间贝伐单抗和曲安西龙治疗可以减缓糖尿病黄斑水肿和视网膜病变的进展，而行PRP术的最佳时机尚有待进一步评估。

　　主题词：Angiogenesis Inhibitors; Antibodies, Monoclonal; Diabetic Retinopathy; Disease Progression; Glucocorticoids; Humans; Laser Coagulation; Macular Edema; Phacoemulsification; Triamcinolone Acetonide; Vascular Endothelial Growth Factor A;