Abstract
Purpose :
To evaluate the effect of uneventful phacoemulsification on central macular thickness (CMT) using spectral-domain optical coherence tomography (SD-OCT) of the macula
Methods :
A prospective non-comparative study including 30 eyes of 28 patients who underwent uneventful phacoemulsification surgery. Exclusion criteria included patients < 18 years, dense cataract or corneal opacity interfering with imaging, baseline macular pathologies i.e., diabetic macular edema (DME), age-related macular degeneration (AMD), and intraoperative posterior capsular rupture. Prior to surgery, all patients underwent a comprehensive ophthalmological exam and SD-OCT 6-×6-mm raster scan centered on the macular area (Heidelberg Engineering, Heidelberg, Germany). SD-OCT was repeated at 1-month and 3-month postoperative visits.
Results :
The mean age of the patients was 58.57 ± 5.13 years. Nuclear cataract grade 2 was the most common cataract type in 24 eyes (80 %). Log MAR of visual acuity (VA) improved from 0.78 ± 0.26 to 0.14 ± 0.17 (p < 0.001). CMT changed from 260.40 ± 19.09 µm preoperatively to 279.00 ± 59.80 µm at month 1 (p = 0.043) and 265.40 ± 20.50 µm at month 3 (p=0.06) postoperatively. Effective phacoemulsification time (EPT) was 5.64 ± 1.24 seconds. A positive correlation was inferred between EPT and CMT change at month 1 (r=0.469, p = 0.009) and month 3 (r= 0.365, p= 0.048). None of the patients had clinically significant macular edema or decrease of VA related to macular edema.
Conclusions :
A subclinical increase in CMT following uncomplicated phacoemulsification surgery was noted in the early postoperative period that could be due to surgical-induced inflammatory mediators release, mild intraoperative trauma from the surgery and fluidic changes, and the alteration of the vitreous position after the removal of the crystalline lens. Studies with a larger number of participants are needed to confirm our findings.
This is a 2021 Imaging in the Eye Conference abstract.