Objective To explore the effect of early pupil dilation after surgery on ocular hemodynamics in patients with diabetic retinopathy (DR) complicated with cataract, and to analyze the related factors affecting pupil diameter up to standard after dilation. Methods 150 patients with DR complicated with cataract who were treated in cataract surgery in our hospital ophthalmology from January 2018 to January 2022 were selected, the patients were evenly divided into control group and observation group by random number table method, two groups were given compound topicamide eye drops to dilate pupil after surgery, pupils were dilated once on 7d, and 14d after surgery in the control group, early pupil which beganing to dilate pupil once a day on the next day after surgery were dilated in the observation group. The changes and differences of ocular after surgery hemodynamics between the two groups were compared. According to whether the pupil diameter reaches the standard after pupil dilation on the 14th day after operation, the patients were divided into the standard group (pupil diameter ≥5mm) and the non-standard group (pupil diameter<5mm), clinical data of patients were collected, multivariate Logistic regression was used to analyze the factors affecting whether the pupil diameter reached the standard after pupil dilation. Results: The central retinal artery, short posterior ciliary artery end diastolic flow velocity (EDV) and peak systolic velocity (PSV) of the observation group increased 14d after surgery compared with 7d after surgery (P < 0.05), resistance index decreased compared with 7d after operation (P < 0.05), EDV and PSV of central retinal artery and short posterior ciliary artery were higher than those of control group at 7d and 14d after surgery (P < 0.05), RI was lower than that of control group (P < 0.05). The pupil dilation time of observation group on 14d after surgery was shorter than that on 7d after surgery (P < 0.05), the pupil diameter after pupil dilation increased compared with 7d after operation (P < 0.05), the pupil dilation time of the observation group was shorter than that of the control group on the 7d and 14d after operation (P < 0.05), and the pupil diameter after pupil dilation was larger than that of the control group (P < 0.05). The duration of diabetes > 10 years and the DR proliferative period were the risk factors affecting pupil diameter after pupil dilation (P < 0.05), and early postoperative dilation was a protective factor (P < 0.05). Conclusion In patients with cataract complicated with DR, early postoperative dilation can shorten the duration of pupil dilation of pupil, improve ocular hemodynamics, and increase pupil diameter after pupil dilation. The duration of diabetes, the severity of diabetic retinopathy and the timing of dilate pupils after surgery are the influencing factors of pupil diameter after pupil dilation. |