Effects Of Intraocular Pressure On Peripapillary And Macular Vascular Density Result From Cataract Surgery: An Optical Coherence Tomography Angiography Study

Purpose: Optical Coherence Tomography Angiography(OCTA)was used to study the influence of cataract surgically induced intraocular pressure(IOP)fluctuating on macular and peripapillary vessel density in cataract patients.Methods: This was a prospective study.A total of 52 patients(52 eyes)undergoing cataract phacoemulsification combined with intraocular lens implantation at the Department of Ophthalmology,Affiliated Hospital of Qingdao University from May 2017 to October 2017 were enrolled.Subjects income criteria: no other eye diseases(except cataract),no intraoperative and postoperative complications.IOP was measured by a non-contacttonometer and macular and peripapillary vascular density were measured by OCTA before cataract surgery,and immediately,60 min,8h,24 h after cataract surgery.Results: Compared with pre-operation,macular and peripapillary perfusion density decreased at 0min after cataract surgery(P<0.05),and macular perfusion density still decreased at 60 min after cataract surgery(P<0.05).Macular and peripapillary vascular density decreased at 0min after cataract surgery(P<0.05),and then recovered at 60 min after cataract surgery(P>0.05).At 8h after cataract surgery,the vascular and perfusion density of macular and peripapillary did not change when IOP was lower than 30 mmHg(P>0.05).The perfusion density of macular and peripapillary decreased when IOP was higher than 30 mmHg(P<0.05).The vascular and perfusion density all decreased when IOP was higher than 40 mmHg(P<0.05).At 24 h after cataract surgery,the vascular and perfusion density of macular and peripapillary did not change when IOP was lower than 30 mmHg(P>0.05).The perfusion density of macular decreased when IOP was higher than 30 mmHg(P<0.05).The vascular and perfusion density of macular and peripapillary all decreased when IOP was higher than 40 mmHg(P<0.05).Conclusions: Fundus vascular and perfusion density decreased result from the elevated intraoperative perfusion pressure;the perfusion density still did not recovered at 60 min after cataract surgery.Intraocular pressure fluctuation after cataract surgery affects the vascular and perfusion density of the fundus.The perfusion density decreased when the IOP was higher than 30 mmHg.And the vascular and perfusion density all decreased when the IOP was higher than 40 mmHg.