Early OCT Angiography Variations in Macular and Peripapillary Area after Uncomplicated Cataract Surgery and Correlation with Intraoperative Parameters

Abstract

Background: We evaluated changes in both macular and peripapillary vascular parameters, evaluated by OCT angiography (OCTA), after uncomplicated cataract surgery, as well as the influence of effective phacoemulsification time (EPT) and cumulative dissipated energy (CDE). Methods: This is prospective study on 130 eyes of 65 individuals who underwent unilateral phacoemulsification, with fellow eyes data taken as control group. We collected cataract grading, EPT and CDE. Best corrected visual acuity (BCVA), superficial vessel density, deep vessel density, foveal avascular zone (FAZ) parameters and peripapillary capillary density were measured at baseline, one week and one month following surgery. Results: When compared to baseline, there was a significant increase in both superficial and deep foveal density at last follow up (from 42.9 ± 4.2 and 37.3 ± 7.4 to 45.6 ± 5.4 and 43.7 ± 9.0%, p = 0.002 and p = 0.0001, respectively). Both foveal avascular zone’s area and perimeter showed a significant decrease compared to the preoperative value (p < 0.05). On the other hand, peripapillary vascular density showed a significant increase at week one (from 49.6 ± 2.7 to 51.4 ± 4.6%, p = 0.01), which returned to preoperative values at last follow up (49.3 ± 4.0%, p = 0.95). We found no significant differences when dividing the cohort for cataract severity. Moreover, no significant effect of the EPT and CDE on vascular changes were reported. Conclusions: We found a significant increase in the vascular parameters of the macular area after cataract surgery, while peripapillary vascular density only experienced a transient increase, suggesting an adaptative metabolic mechanism in response to increased light exposure after surgery.