| Objective: Phacoemulsification cataract surgery with intraocular lens implantation has become the most commonly used procedure in the treatment of cataract.Whether the use of specific perfusion and other factors that induce intraocular pressure fluctuation during surgery will affect the fundus hemodynamics of patients is worth further study.This study was designed to prospectively evaluate changes of fundus vessel densities in patients before and after phacoemulsification cataract surgery using OCTA.Methods: 1.All subjects were from a Han Chinese population and were recruited from June,2019 to December,2019 in Tianjin Eye Hospital(Tianjin,China).32 normal eyes(30 patients),28 short eyes(25 patients)and 25 long eyes(20 patients)were included.Three-dimensional retinal blood vessel images were obtained non-invasively with OCTA 1 day before surgery and 1 day,1 week,and 1 month after surgery.A 6mm × 6mm scanning area centered on the macula and a 4.5mm × 4.5mm scanning area centered on the optic were acquired.2.All patients underwent systematic eye examinations before surgery.OCTA image acquisition was performed by a skilled physician and image evaluation was performed by another experienced physician.3.Cataract surgery was performed by the same experienced physician in all patients.The main surgical parameters on the phacoemulsifier(cumulative dissipated energy,CDE;effective phacoemulsification time,EPT)were recorded after the operation.4.Sort out the above data,apply SPSS 25.0 to process and analyze the data.Results: 1.Macular vascular parameters In all three groups,the superficial and deep retinal vascular densities(SRVD and DRVD)increased from 1 day to 1 week after surgery(both P<0.05).Parameters of normal eyes stabilized at the higher level than the vascular parameters before surgery(both P<0.05).While DRVD of the short eyes was more affected by the surgery,and the SRVD of the long eyes fluctuated longer after surgery.2.Parameters of optic disc In normal eyes and short eyes,VD of inside disc increased from 1 day to 1 week after surgery(P<0.05)and reached preoperative level,while there was no significant change in the VD of pericapillary before and after surgery(P>0.05).Parameters of long eyes had no significant change before and after surgery(all P>0.05).In all three groups,the p-RNFL thickness decreased on the first day after operation(P<0.05),and increased from 1 day to 1 week postoperatively(P<0.05).3.There was no significant difference in the changes in fundus vessel density of the three groups before and after surgery(P>0.05).4.Correlation analysis showed that main surgical parameters(CDE,EPT)have no correlation with the degree of fundus blood flow changes before and after surgery.There was no significant statistical correlation between macular vessel density and BCVA after surgery in all groups(all P>0.05).Conclusions: 1.OCTA can be used as a reliable method to study the changes of fundus blood flow in patients with mild to moderate cataract.2.Phacoemulsification cataract surgery with intraocular lens implantation can improve macular blood flow in patients with normal eyes and macular perfusion in patients with short and long eyes could recover to preoperative level in one week.3.The surgery mainly affected p-RNFL thickness and blood perfusion inside optic disc.This parameters recovered to baseline levels in one week postoperatively.4.In the absence of vascular lesions and smooth surgical procedures,the surgery did not significantly of affect the change of vessel density in patients with different axial lengths and fundus vessel density may not be the key factor for patients’ postoperative vision.5.Surgery does not have the same effect on different fundus layers of blood perfusion of patients with different axial lengths.DRVD in short eyes and SRVD in long eyes fluctuated longer in macula,and long eyes were affected least in optic disc. |
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