ESCRS - PO0318 - Long-Term Functional Hyperemia After Uncomplicated Phacoemulsification: Benefits Beyond Restoring Vision

Long-Term Functional Hyperemia After Uncomplicated Phacoemulsification: Benefits Beyond Restoring Vision

Published 2023 - 41st Congress of the ESCRS

Reference: PO0318 | Type: Free paper | DOI: 10.82333/3mjf-c929

Authors: Ana Ćurić* 1 , Mirjana Bjeloš 2 , Mladen Bušić 2 , Biljana Kuzmanović Elabjer 2 , Benedict Rak 3

1University Eye Department,University Hospital "Sveti Duh",Zagreb,Croatia;Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek,Osijek,Croatia, 2University Eye Department,University Hospital "Sveti Duh",Zagreb,Croatia;Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek,Osijek,Croatia;Faculty of Medicine, Josip Juraj Strossmayer University of Osijek,Osijek,Croatia, 3University Eye Department,University Hospital "Sveti Duh",Zagreb,Croatia

Purpose

To investigate long-term effects of uncomplicated phacoemulsification on macular perfusion, using optical coherence tomography angiography (OCTA) in healthy aging subjects

Setting

University Eye Department, Reference Centre of the Ministry of Health of the Republic of Croatia for Pediatric Ophthalmology and Strabismus, Reference Centre of the Ministry of Health of the Republic of Croatia for Inherited Retinal Dystrophies, University Hospital “Sveti Duh”, Zagreb, Croatia

Methods

Patients with incipient and immature senile cataracts (Pentacam® nucleus staging system 1, 2 or 3) who underwent uncomplicated phacoemulsification were included in the study. OCTA was performed before cataract surgery, 1 week, 1 month, 3 months, and 6 months after surgery using spectral domain OCTA. Superficial vascular complex (SVC), formed of nerve fiber layer vascular plexus (NFLVP) and superior vascular plexus (SVP), deep vascular complex (DVC), formed of intermediate capillary plexus (ICP) and deep capillary plexus (DCP), as well as choriocapillaris (CC) and large choroidal blood vessels were recorded.

Results

Explant area (EA), vessels area (VA), vessels percentage area (VPA), total number of junctions (TNJ), junctions density (JD), total vessels length (TVL), average vessels length (AVL), total number of end points (TNEP), mean lacunarity (ML), and foveal avascular zone (FAZ) surface throughout all layers were analyzed. Significant changes of vascular parameters in 95 eyes of 95 patients reached plateau 1 week after surgery and remained stable up to 6 months, occurring in all retinal layers but not in choroid and CC. Statistically significant increase in retinal VA, VPA, TNJ, JD, TVL and AVL, followed by significant TNJ and ML decline, proved an increase in macular blood supply after phacoemulsification.

Conclusions

The study confirmed that uncomplicated phacoemulsification leads to a long-term increase in macular retinal perfusion. Increased retinal perfusion had no clinically significant effect on choroidal circulation as the threshold to cause a breakdown of the external blood-retinal barrier was not reached. The results might ease the decision regarding timing for cataract surgery as long-term perfusion benefits, beyond restoring visual acuity and reducing intraocular pressure, can be achieved.