Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2022, Vol. 36 ›› Issue (4): 97-102.doi: 10.6040/j.issn.1673-3770.0.2022.020

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A clinical study on the effect of phacoemulsification on the retinal structure in the macular region of senile cataract

YANG Ru1, ZHANG Yuguang2, XU Xianghui3, WU Xuelian3, TAO Yuan3, TAN Yue3   

  1. 1. The School of Clinical Medical, Weifang Medical University, Weifang 261042, Shandong, China;
    2. Department of Ophthalmology, School of Clinical Medicine, Weifang Medical University, Weifang 261042, Shandong, China;
    3.Department of Ophthalmology, The Jinan Second People's Hospital, Jinan 250000, Shandong, China
  • Published:2022-07-11

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Abstract: Objective Optical coherence tomography angiography(OCTA)is used to observe the changes of blood flow density, retinal thickness, and foveal avascular zone(FAZ)in the macular region after phacoemulsification in patients with senile cataract. The objective of this study is to explore the influence of intraoperative parameters on the structural changes of the macular area and to explore the factors affecting postoperative visual acuity. Methods This is a prospective observational study. Patients with senile cataract who underwent phacoemulsification before operation, and 1 day, 1 week, 1 month, and 3 months after operation, underwent imaging of the macular area using the 3×3 mm OCTA scan to obtain the macular blood flow density, thickness of the retina, and the area of FAZ. Cumulative release energy(CDE)and effective phacoemulsification time(EPT)were recorded, and their correlation with the changes of macular retinal structure was analyzed. Using binary logistic regression analysis to explore the factors affecting postoperative visual acuity. Results Forty-one cases(41 eyes)were included in the final analysis. Compared with those before operation, the linear density and perfusion density of the macular area increased at 1 day, 1 week, 1 month, and 3 months after operation(P<0.05), and the FAZ area decreased(P<0.001); the retinal thickness in the macular increased at 1 month and 3 months after operation compared with preoperative(P<0.05). There was no correlation between CDE and EPT and macular retinal structural changes(P>0.05), and postoperative best corrected visual acuity(BCVA)had no correlation with macular blood flow density, retinal thickness, FAZ area, CDE and EPT(P>0.05). Conclusion After phacoemulsification, the blood flow density and retinal thickness in the macular increased, and the FAZ area decreased. The surgical parameters were not the main factors that caused changes of the postoperative retinal structure. The changes in surgical parameters and retinal structure had no effect on postoperative visual acuity. We should further explore the reasons for the changes of postoperative retinal structure in the macular region and the factors affecting the recovery of postoperative visual acuity.

Key words: Optical coherence tomography angiography, Phacoemulsification, Senile cataract, Blood flow density, Retinal thickness, Foveal avascular zone

CLC Number: 

  • R776.1
[1] 齐跃东. 某居民区50岁及以上人群白内障情况调查[J]. 中华眼外伤职业眼病杂志, 2017, 39(1): 42-45. doi:10.3760/cma.j.issn.2095-1477.2017.01.012. QI Yuedong. Epidemiological survey on incidence of cataract in persons of 50 years or over in a resident district[J]. Chinese Journal of Ocular Trauma and Occupational Eye Disease, 2017, 39(1): 42-45. doi:10.3760/cma.j.issn.2095-1477.2017.01.012.
[2] Hilton EJ, Hosking SL, Gherghel D, et al. Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics[J]. Eye(Lond), 2005, 19(6): 670-675. doi:10.1038/sj.eye.6701620.
[3] Zhao ZN, Wen W, Jiang CH, et al. Changes in macular vasculature after uncomplicated phacoemulsification surgery: optical coherence tomography angiography study[J]. J Cataract Refract Surg, 2018, 44(4): 453-458. doi:10.1016/j.jcrs.2018.02.014.
[4] Zhou YF, Zhou MW, Wang YL, et al. Short-term changes in retinal vasculature and layer thickness after phacoemulsification surgery[J]. Curr Eye Res, 2020, 45(1): 31-37. doi:10.1080/02713683.2019.1649703.
[5] 刘俊, 廖荣丰. 基于OCTA的白内障超声乳化术后黄斑区视网膜厚度和血管密度分析[J]. 眼科新进展, 2020, 40(4): 377-380. doi:10.13389/j.cnki.rao.2020.0087. LIU Jun, LIAO Rongfeng. Changes of macular retinal thickness and vessel density after phacoemulsification using optical coherence tomography angiography[J]. Recent Advances in Ophthalmology, 2020, 40(4): 377-380. doi:10.13389/j.cnki.rao.2020.0087.
[6] Pilotto E, Leonardi F, Stefanon G, et al. Early retinal and choroidal OCT and OCT angiography signs of inflammation after uncomplicated cataract surgery[J]. Br J Ophthalmol, 2019, 103(7): 1001-1007. doi:10.1136/bjophthalmol-2018-312461.
[7] 李锐, 李勇, 谢洪涛, 等. 眼压波动对人工晶体植入术患者眼底黄斑及视盘血流密度的影响分析[J]. 山东大学耳鼻喉眼学报, 2020, 34(1): 89-92. doi:10.6040/j.issn.1673-3770.0.2019.280. LI Rui, LI Yong, XIE Hongtao, et al. Effects of intraocular lens implantation and postoperative intraocular pressure fluctuations on the fundus macular and optic disc vascular density[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 89-92. doi:10.6040/j.issn.1673-3770.0.2019.280.
[8] Perente I, Utine CA, Ozturker C, et al. Evaluation of macular changes after uncomplicated phacoemulsification surgery by optical coherence tomography[J]. Curr Eye Res, 2007, 32(3): 241-247. doi:10.1080/02713680601160610.
[9] 施毓琳, 徐国兴. 白内障术后人工晶状体眼黄斑囊样水肿的研究进展[J]. 国际眼科杂志, 2020, 20(9): 1539-1542. doi:10.3980/j.issn.1672-5123.2020.9.14. SHI Yulin, XU Guoxing. Research progress of pseudophakic cystoid macular edema[J]. International Eye Science, 2020, 20(9): 1539-1542. doi:10.3980/j.issn.1672-5123.2020.9.14.
[10] de Maria M, Iannetta D, Cimino L, et al. Measuring anterior chamber inflammation after cataract surgery: a review of the literature focusing on the correlation with cystoid macular edema[J]. Clin Ophthalmol, 2020, 14: 41-52. doi:10.2147/OPTH.S237405.
[11] Miyake K. Prostaglandins levels in the aqueous of vitreous tug syndrome and their changes by pars Plana vitrectomy(author's transl)[J]. Nippon Ganka Gakkai Zasshi, 1980, 84(10): 1461-1467. doi:10.1016/s0886-3350(02)01243-9.
[12] 丛玮霞, 张仲臣, 郝晓琳. 糖尿病患者白内障术后黄斑区厚度改变机制的现况研究[J]. 国际眼科杂志, 2017, 17(5): 888-890. doi:10.3980/j.issn.1672-5123.2017.5.21. CONG Weixia, ZHANG Zhongchen, HAO Xiaolin. Mechanism of the macular fovea thickness change after cataract surgery in diabetic patients[J]. International Eye Science, 2017, 17(5): 888-890. doi:10.3980/j.issn.1672-5123.2017.5.21.
[13] Liu J, Liu Q, Yu H, et al. Microvascular changes in macular area after phacoemulsification and its influencing factors assessed by optical coherence tomography angiography[J]. Ther Clin Risk Manag, 2021, 17: 405-414. doi:10.2147/TCRM.S309679.
[14] Vasavada AR, Praveen MR, Vasavada VA, et al. Impact of high and low aspiration parameters on postoperative outcomes of phacoemulsification: randomized clinical trial[J]. J Cataract Refract Surg, 2010, 36(4): 588-593. doi:10.1016/j.jcrs.2009.11.009.
[15] 旷琳, 杨蕾蕾. 白内障超声乳化人工晶状体植入术后黄斑中心凹视网膜厚度与最佳矫正视力的相关性研究[J]. 眼科新进展, 2014, 34(12): 1167-1169. doi:10.13389/j.cnki.rao.2014.0324. KUANG Lin, YANG Leilei. Relationship between macular foveal retinal thickness and BCVA after phacoemulsification and IOL implantation[J]. Recent Advances in Ophthalmology, 2014, 34(12): 1167-1169. doi:10.13389/j.cnki.rao.2014.0324.
[16] Jia XY, Wei YJ, Song H. Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal eyes[J]. Int Ophthalmol, 2021, 41(12): 4175-4185. doi:10.1007/s10792-021-01987-8.
[17] 彭稚薇, 徐飞, 秦贤杰. OCTA技术在白内障术后黄斑微循环变化中的应用[J]. 影像科学与光化学, 2021, 39(6): 854-859. doi:10.7517/issn.1674-0475.210509. PENG Zhiwei, XU Fei, QIN Xianjie. Application of OCTA technique in macular microcirculation after cataract surgery[J]. Imaging Science and Photochemistry, 2021, 39(6): 854-859. doi:10.7517/issn.1674-0475.210509.
[18] Feng L, Azhati G, Li TT, et al. Macular vascular density changes following cataract surgery in diabetic patients: an optical coherence tomography angiography study[J]. J Ophthalmol, 2021, 2021: 6641944. doi:10.1155/2021/6641944.
[19] Gharbiya M, Cruciani F, Cuozzo G, et al. Macular thickness changes evaluated with spectral domain optical coherence tomography after uncomplicated phacoemulsification[J]. Eye(Lond), 2013, 27(5): 605-611. doi:10.1038/eye.2013.28.
[20] Balaratnasingam C, Inoue M, Ahn S, et al. Visual acuity is correlated with the area of the foveal avascular zone in diabetic retinopathy and retinal vein occlusion[J]. Ophthalmology, 2016, 123(11): 2352-2367. doi:10.1016/j.ophtha.2016.07.008.
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