Macular Perfusion Analysed by Optical Coherence Tomography Angiography after Uncomplicated Phacoemulsification: Benefits beyond Restoring Vision
Abstract Background: The purpose of the study is to investigate the changes of macular perfusion by OCT-angiography (OCT-A) after uncomplicated phacoemulsification.Methods: OCT-A was performed before cataract surgery, 1 week, 1 month, and 3 months after surgery recording superficial vascular complex (SVC), nerve fiber layer vascular plexus (NFLVP) superior vascular plexus (SVP), deep vascular complex (DVC), intermediate capillary plexus (ICP) and deep capillary plexus (DCP), as well as large choroidal blood vessels and choriocapillaris (CC) were recorded. 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 E lacunarity (MEL), and foveal avascular zone (FAZ) area throughout all layers were analysed.Results: Significant changes of vascular parameters in 55 eyes of 55 patients mostly reached plateau one week after surgery and remained stable up to three months after surgery, occurring in all retinal layers but not in choroid and choriocapillaris. Changes of FAZ area ensued across all retinal layers within one month after surgery. The greatest increase in VPA (22.79%), TVL (16.71%), AVL (166.71%) and JD (29.49%) was in SVC causing the largest FAZ surface decrease (-25.54%) in SVC likewise. On the contrary, the greatest change of MEL (-53.41%) appeared in DVC.Conclusions: This is the first OCT-A study demonstrating that perfusion alterations observed in macula after phacoemulsification are response to functional hyperaemia prompted by augmented visual stimulation. Phacoemulsification in elderly population proved as advantageous feature in addition to restoring visual acuity.