Jornal de Oftalmologia Clínica e Experimental
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Assessment of Microvascular Changes using Optical Coherence Tomography Angiography after Phacoemulsification Surgery in an Indian Population

Supriya Dabir*, Mohan Rajan, Sujatha Mohan, Vaidehi Bhatt, M.Ravishankar, Sowmya Sunil, Deepak Bhatt, Preetam Samant, Berendschot TTJM, Webers CAB6

Purpose: To identify changes in superficial retinal capillary microvasculature before and after cataract surgery using optical coherence tomography angiography (OCTA).

Setting: Rajan eye care, Tertiary care center in Chennai, India.

Design: Prospective observational study.

Methods: Patients above 40 years who underwent uncomplicated cataract surgery had 6 × 6 mm OCTA foveacentered scans using Zeiss Angioplex 5000 OCTA before and 4 weeks postoperatively. Signal strength and automated values obtained for perfusion density (PD) and vascular density (VD) were recorded.

Results: Fifty-eight eyes of 33 patients aged 67 ± 5 years were enrolled. Signal strength (3.9 ± 2.3 vs. 5.7 ± 2.1, p<0.001), PD (16.4 ± 10.4 vs. 26.6 ± 10.3, p<0.001) and VD (7.4 ± 4.5 vs. 11.4 ± 4.0, p<0.001) increased significantly after surgery. Strong positive correlation was seen between signal strength and PD (r=0.86, p<0.001) and VD (r=0.79, p<0.001). Linear mixed model analysis with eye as grouping factor, time (i.e. pre and post-surgery) and signal strength as covariates showed, surgery independently caused an increase in PD (ß=3.63 increment in PD after surgery, p<0.001) and VD (ß=1.61 increment in VD after surgery, p=0.003). After adjusting for signal strength, a 20% increment in macular PD and VD was observed in central 1 mm area around fovea. Foveal avascular zone (FAZ) area, perimeter and circularity, did not change after surgery.

Conclusion: Macular perfusion and vascularity indices increase immediately after cataract surgery independent of improvement in signal strength, though FAZ is not influenced.