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What to do when diabetic retinopathy and cataracts meet in a narrow way?

Posting time:2022-12-03 10:48:52

What to do when diabetic retinopathy and cataracts meet in a narrow way?

Diabetic patients need to have an eye health check every six months. "As long as blood sugar is well controlled, diabetic retinopathy is not a problem for him." Many people with diabetes may think so. In fact, controlling blood sugar only reduces the probability of developing diabetic retinopathy, not preventing the disease. Diabetic retinopathy is related to the course of diabetes and the degree of control. Generally, the longer the course of disease, the higher the risk of developing diabetic retinopathy. In addition to maintaining stable blood sugar control, it is especially important for diabetic patients to go to the hospital for an eye health check every six months. Early detection and early treatment can still maintain good vision for most patients. Cataract surgery can be performed when blood sugar is stable. First of all, diabetes does not directly cause problems with coagulation function, but if the blood sugar value is unstable for a long time, it will still affect the blood coagulation function to a large extent. Therefore, for diabetic patients, before cataract surgery, it is necessary to control the patient's blood sugar to reach the normal range. Under normal circumstances, the fasting blood glucose level should be below 8mmol/L before cataract surgery can be performed. In addition, when cataract patients undergo surgery, not only blood sugar checks, but also a complete preoperative examination, including routine examinations for hypertension, cardiopulmonary function, etc., must be performed on the patient. However, it is unavoidable that patients with other underlying diseases such as diabetes have a higher risk than ordinary patients for cataract surgery. Who to rule first? Diabetic retinopathy vs cataract Cataract surgery is not required when mild cataract has no obvious visual impairment and does not affect the observation of the fundus. Moderate cataract complicated with diabetic retinopathy first understand the severity of diabetic retinopathy and whether there is macular edema. After stabilization, consider cataract surgery. Severe cataract combined with diabetic retinopathy If the fundus condition is difficult to assess, cataract surgery should be performed first, followed by fundus examination as soon as possible to determine the fundus condition. If diabetic macular edema already exists, anti-neovascular treatment can be performed before or at the same time as cataract surgery or after cataract surgery. If intraocular hemorrhage or traction retinal detachment has occurred, cataract combined with vitrectomy and retinal reattachment can be combined to save the eye.

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