Changes in macular vasculature after uncomplicated phacoemulsification surgery: Optical coherence tomography angiography study

Purpose: To use optical coherence tomography (OCT) angiography and a split-spectrum amplitude-decorrelation angiography algorithm to evaluate the changes in the macular vascular system after uncomplicated phacoemulsification. Setting: Department of Ophthalmology, Eye and and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China. Design: Prospective case series. Methods: Patients with senile cataracts were included. Retinal vessel density and thickness at the macular area were checked by OCT at baseline and at 1 week, 1 month, and 3 months after cataract surgery. Results: Thirty-two eyes (32 patients) were included in the final analysis. There was a significant increase in retinal vessel density, a decrease in the foveal avascular zone at the macular area after the cataract surgery (all P < .05, repeated-measures analysis of variance), and an increase in full and inner macular thickness, all of which extended to the end of the follow-up period. At 3 months postoperatively, there was a mean 6% and 3% increase in vessel density at the parafoveal and perifoveal regions, respectively, and a mean 27% reduction in the foveal avascular zone. The mean increase in inner retinal thickness was 15%, 10%, and 7% at the fovea, parafovea, and perifovea, respectively. Compared with the parafovea and perifovea, the fovea had a much higher percentage of change in retinal vasculature and inner retinal thickness (all P < .001). Conclusions: Macular vessel density and thickness increased after cataract surgery. Whether these changes will persist over a longer period still needs to be studied.