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OCT angiography of the optic nerve and macula blood flow following clear cornea cataract surgery

Poster Details

First Author: E.Tsichlis GREECE

Co Author(s):    A. Kanellopoulos   G. Asimellis   I. Kontari        

Abstract Details

Purpose:

To evaluate the effect of small-incision clear-cornea cataract surgery on optic nerve and macula blood flow studied with OCT Angiography and potentially screen for subclinical Irvine-Gass syndrome.

Setting:

LaserVision.gr Clinical and Research Eye Institute, Athens, Greece

Methods:

We evaluated 35 consecutive eyes undergoing clear-cornea cataract surgery (17 phacoemulsification, 18 femtosecond laser-assisted (LenSx, Alcon, Ft. Worth, TX) capsulotomy and lens fragmentation. We evaluated visual acuity, refraction, keratometry, tomography, pachymetry, endothelial cell counts, and intraocular pressure. AngioVue Imaging System (Optovue, Fremont, CA).images of the optic nerve and macula were obtained preoperatively, at day-1, week-1 and week-4. The Angioview images were obtained at 70 kHz A-scans-per-second using the SSADA algorithm, constructing angiography of the retinal and choroidal microvasculature, with the ability to isolate vasculature and circulation in individual layers of customized height in the retina and choroid.

Results:

In 21/35 cases preoperative pictures were of adequate quality to be analyzed and compared to postoperative, mainly due to cataract-related media opacity. Optic nerve angioflow showed transient increase (both at radial peripapillary level and on optic disc blood flow) at day-1 in 5 cases (2 manual and 3 femto-assisted), not obvious thereafter. There was no macula angioflow detectable deviation from baseline at any follow-up interval. This applies for all four levels studied: superficial capillary, deep capillary, outer retina, choriocapillary layers, suggesting transient Irvin-Gass syndrome. There was no statistical difference in the findings between the manual vs femto-assisted subgroups.

Conclusions:

This is a novel, non-invasive objective technique in evaluating potential optic nerve and or macula microvascular changes. Transient vascular flow pathology was evident in uneventful clear cornea cataract surgery with this non-invasive vascular flow study. These data may caution clinicians in the post-operative anti-inflammatory regimen chosen and used as long as its duration of administration. FINANCIAL DISCLOUSRE: One or more of the authors travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented

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