Macular Morphology After Cataract Surgery With And Without Primary Posterior Continuous Curvilinear Capsulorhexis: A Randomized Intraindividual Comparative Clinical Trial

To evaluate changes in macular morphology after cataract surgery with and without primary posterior continuous curvilinear capsulorhexis (PPCCC).

The prospective, intraindividual, comparative randomized controlled trial was conducted at Fuzhou University Affiliated Provincial Hospital in Fujian, China, between December 2023 and May 2024. 

One hundred and thirty eyes of 65 age-related cataract patients with normal macular morphology and function waiting for bilateral cataract surgery and intraocular lens (IOL) implantation were enrolled. Cataract surgery combined with PPCCC was performed in one eye, and routine cataract surgery in the fellow eye (NPCCC group). Optical coherence tomography (OCT) measurements were performed in all patients preoperatively and postoperatively on 1 day, 1 week,1 month, and 3 months. Corrected distance visual acuity (CDVA) was also measured at at each visit.

One hundred and twenty eyes of 60 patients were capable to complete scheduled follow-ups and analyzed in the study. There was no statistically significant difference between the PPCCC group and NPCCC group in terms of subfoveal central retinal thickness (CRT), central 1-mm subfield (CSF), average retinal thickness of 1-3mm middle and 3-6mm outer rings at all timepoints postoperatively(P>0.05). Three eyes developed cystoid macular edema (CME) 1-month post-surgery. One eye in the PPCCC group recovered in two weeks after topical treatment, while two in the NPCCC group took eight weeks to recover. In the NPCCC group, PVD progressed in two eyes. No PVD progression in the PPCCC group. The CDVA of all patients was logMAR 0.1 or better at 3 month.

Cataract surgery with combined manual PPCCC does not increase the risk of CME and PVD in patients. PPCCC is a safe cataract surgery technique.