Effect of cataract surgery on subfoveal choroidal and ganglion cell complex thicknesses measured by enhanced depth imaging optical coherence tomography

Assessment of the Retinal Ganglion Cell Layer after Uncomplicated Cataract Surgery

(1) Background: This research aimed to evaluate the changes in ganglion cell layer thickness (GCLT) after uncomplicated cataract surgery in patients without previous ocular pathology and the impact of the appearance of cystoid macular edema on the GCLT and visual acuity. (2) Methods: The evaluation of 174 patients was performed with the indication of uncomplicated cataract surgery. The variables analyzed were demographic data, best-corrected visual acuity (BCVA), cataract type and OCT (Optical Coherence Tomography) measurements of central macular thickness (CMT), and the presence of cysts and GCLT preoperatively and one day, one and three months after surgery. (3) Results: There was a relationship between the postoperative increase in retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts reduced the thickness of the GCL, which is significantly related to the loss of BCVA. The appearance of cystoid macular edema one month after surgery was also related to the preoperative CMT. There was a statistically significant decrease in preoperative GCL but a statistically significant increase in preoperative CMT in patients with microcysts one-month post-surgery. (4) Conclusions: There is a relationship between postoperative retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts significantly reduces the thickness of the GCL, which is significantly related to the loss of BCVA.

The effect of trifocal and extended-depth-of-focus intraocular lenses on optical coherence tomography parameters

PURPOSE

Optical properties of commonly used multifocal and extended-depth-of-focus (EDOF) intraocular lenses (IOLs) can induce artifacts or changes in optical coherence tomography (OCT) measurements. Our purpose was to investigate the possible effects of different IOLs on peripapillary and macular OCT parameters.

METHODS

The preoperative and postoperative third-month peripapillary OCT and ganglion cell analysis (GCA) parameters of patients having monofocal (Alcon IQ), multifocal (PanOptix), or EDOF (Vivity) IOL implanted during cataract surgery were compared.

RESULTS

Sixty-four eyes of 64 patients were included (21 monofocal, 24 multifocal, and 19 EDOF). Although all OCT image qualities increased postoperatively, only GCA image quality changes in the monofocal and multifocal groups reached statistical significance. Most peripapillary retinal nerve fiber layer (RNFL) and GCA parameters were similar preoperatively and postoperatively. The superior RNFL thickness in the monofocal group and the temporal RNFL thickness in the EDOF group were higher postoperatively ( P = 0.04 and P = 0.02, respectively). Most GCA and RNFL value changes between preoperative and postoperative measurements were similar between groups. In the parameters that changed, postoperative values were higher in the monofocal group ( P = 0.02 for minimum ganglion cell layer and inner plexiform layer, P = 0.04 for average RNFL).

CONCLUSION

Trifocal and EDOF IOLs do not seem to have a negative effect on OCT parameters.

Effect of Conventional Cataract Surgery and Femtosecond Laser-Assisted Cataract Surgery on Bruch's Membrane Opening-Minimum Rim Width, Retinal Nerve Fiber Layer, and Macular Thickness

Purpose

To evaluate the effect of conventional cataract surgery (CCS) and femtosecond laser-assisted cataract surgery (FLACS) on Bruch's membrane opening-minimum rim width (BMO-MRW), peripapillary retinal nerve fiber layer thickness (RNFL), and macular thickness (MT) using spectral-domain optical coherence tomography (SD-OCT).

Methods

BMO-MRW, RNFL, and MT were measured using SD-OCT preoperatively, 1 month and 6 months after surgery in both CCS and FLACS groups. Differences between preoperative and postoperative values were evaluated in both groups. The postoperative changes were evaluated in each group and compared between groups.

Results

A total of 146 eyes of 146 patients were included in this study, 65 underwent CCS, and 81 underwent FLACS. One month after surgery, there was an increase (in microns) of 20.93 in BMO-MRW, 4.26 in RNFL, and 7.85 in MT in CCS group (P < 0.001), and 17.7, 3.73, and 5.65, respectively, in FLACS group (P < 0.001). Six months after surgery, there was an increase of 12.53 in BMO-MRW, 1.42 in RNFL, and 4.72 in MT in CCS group (P < 0.001), and 13.7, 1.88, and 4.14, respectively, in FLACS group (P < 0.001). The postoperative changes in CCS group were similar to those in FLACS group.

Conclusion

CCS as well as FLACS result in a slight increase in BMO-MRW, RNFL, and MT values one month and six months after surgery. Neither CCS nor FLACS lead to a deterioration in the parameters that define the structure of the optic nerve head and the macula. These results suggest that FLACS is as safe as CCS regarding the optic nerve head and the macula in normal eyes.

Effects of Cataract on Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness on Swept Source Optical Coherence Tomography

PURPOSE

To evaluate the changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell-inner plexiform layer (mGC-IPL) thickness measured by swept source optical coherence tomography (SS-OCT) following cataract surgery in patients with glaucoma.

METHODS

We included 42 glaucoma eyes and 42 case-matched normal eyes that underwent cataract surgery without complications. One matching set included one glaucoma eye and one case-matched normal eye. The age, sex, and cataract subtype scores were similar for each group. Before and within 3 months of surgery, we measured the pRNFL thickness and mGCIPL thickness by SS-OCT.

RESULTS

Following cataract surgery, the image quality (IQ) of SS-OCT improved in both groups. The thickness of the pRNFL and mGC-IPL increased in the mean values and all areas, except for pRNFL from 1 to 4 o'clock in the glaucoma group and at 1 o'clock in the normal group. Posterior subcapsular cataract was related to the change in IQ following surgery. The glaucoma and normal group showed greater pRNFL thickness change due to lesser preoperative pRNFL thickness. Furthermore, the mGC-IPL thickness change was greater in the glaucoma group because of lesser preoperative mGC-IPL thickness. By contrast, the normal group demonstrated greater mGC-IPL thickness change due to higher cortical cataract scores.

CONCLUSIONS

Cataracts caused the deterioration of the IQ in SS-OCT, thereby resulting in an undermeasurement of the pRNFL and mGC-IPL thickness. Preoperative pRNFL and mGC-IPL were negatively associated with postoperative pRNFL and mGCIPL thickness change in the glaucoma and normal groups. Therefore, ophthalmologists should particularly consider the effect of cataract while diagnosing glaucoma using SS-OCT.

Impact of Cataract Surgery on IOP and Ocular Structures in Normotensive Patients and Primary and Exfoliation Open-Angle Glaucoma Patients

Purpose

The aim of this study was to evaluate and compare the changes in Intraocular Pressure (IOP) and other ocular parameters: the Anterior Chamber Angle (ACA), Anterior Chamber Volume (ACV), and Anterior Chamber Depth (ACD) during phacoemulsification surgery in Greek patients with normotensive eyes and those with well-controlled Open-Angle Glaucoma (OAG). Additionally, parameters such as the Corneal Thickness (CCT), Axial Length (AL), Central Macular Thickness (CMT), and Retinal Nerve Fibre Layer (RNFL) were also examined.

Patients and Methods

This was a prospective observational case-control study that included 50 phakic eyes, 25 normotensive (Group 1), and 25 with OAG: 15 Primary Open-Angle Glaucoma (POAG) and 10 Exfoliation Glaucoma (EXG) (Group 2). Ophthalmic assessment included IOP measurements, ocular biometry, and anterior and posterior segment optical coherence tomography evaluation of the aforementioned ocular parameters, prior and 6 months after phacoemulsification surgery.

Results

At the 6 months post-operative review, a greater IOP reduction was recorded in eyes with OAG, in comparison to normotensive ones (5.3mmHg and 1.6 mmHg respectively). In addition, a significant but similar increase was recorded in the values of the ACA, ACV, and ACD of both groups between the pre- and the post-op period. Furthermore, the CCT and AL values remained unaltered. Finally, there was a non-statistically significant change in the mean CMT and the mean average RNFL of both groups.

Conclusion

Eyes with OAG tend to undergo a greater reduction in IOP post-phacoemulsification surgery, in comparison to normotensive eyes. This reduction may not be solely attributed to ocular anatomical changes after phacoemulsification surgery but may also be due to the remodeling of the trabecular meshwork and the ciliary body. This may be especially true in the case of OAG eyes, which already start off with a compromised trabecular endothelium prior to surgery.

Relationship between ganglion cell complex thickness and vision in age-related macular degeneration treated with aflibercept

PURPOSE

This study aimed to analyze the correlation between ganglion cell complex thickness (GCCT) and vision compared with the choroidal thickness (CT) and central retinal thickness (CRT) in relation to the outcomes of intravitreal aflibercept treatment for choroidal neovascular membranes secondary to age-related macular degeneration (AMD).

METHODS

This was a prospective, observational study. Forty-three eyes of 38 patients with wet AMD received a monthly loading dose of 2 mg aflibercept by intravitreal injection (IVI) during the first 3 months and were then followed at regular monthly intervals for an average of 10 months by a pro re nata regimen. All patients were examined using spectral domain-optic coherence tomography (OCT) and enhanced depth imaging OCT. According to their response to IVI treatment in the third month, patients were divided into 2 groups, both functionally and anatomically.

RESULTS

Three-month GCCT and optic disc retinal nerve fiber layer thickness (ODRNFLT) had the most correlation with the 10-month vision (p  =  0.002, p  =  0.02, respectively). While baseline GCCT was most correlated with the functional response, baseline CRT was most correlated with the anatomical response (p  =  0.01, p  =  0.004, respectively).

CONCLUSIONS

The results suggest that a reduction in 3-month GCCT indicates a good long-term vision outcome, while a reduction in 3-month ODRNFLT shows a poor long-term vision outcome. The literature suggests that this study is the first to demonstrate that baseline GCCT is more strongly correlated with the functional response than it is with CT and CRT. Hence, GCCT has a prognostic value for vision impairment.

Changes in choroidal and foveal retinal thickness after cataract surgery: Our results

INTRODUCTION

Cataract surgery is the most common ophthalmic surgical procedure worldwide. In addition, the retina and choroid are the tissues most susceptible to damage during cataract surgery. However, conflicting results have been found about the relationship between choroidal thickness (CT), retinal thickness (RT), and cataract surgery.

AIM

To evaluate the changes in CT and foveal retinal thickness (FT) following cataract surgery in standardized conditions.

METHODS

Twenty eyes from 20 patients who experienced uneventful cataract surgery and twenty eyes from 20 age- and sex-matched healthy volunteers were recruited in the study. Optical coherence tomography measurements were obtained for 1 day, 1 week, and 1 month postoperatively and compared with the preoperative and control values. The main outcome measure was through the mean change in CT and FT.

RESULTS

The FT values did not change throughout the follow-up. A statistically significant increase in CT at the macular (P = 0.003) and temporal 1 mm region (P = 0.04) was observed at 1 week following the surgery. However, it decreased to nearly preoperative values at 1 month postoperatively.

CONCLUSION

Although the FT remains stable following uneventful phacoemulsification, the CT changes minimally in the early postoperative period. However, this effect is transient and does not appear to be clinically significant in routine conditions.

Choroidal thickness after phacoemulsification: nonrandomized comparison of postoperative topical ketorolac vs dexamethasone vs combination of ketorolac-dexamethasone eyedrops

PURPOSE

To compare the effect of topical dexamethasone vs ketorolac vs combined dexamethasone-ketorolac after phacoemulsification on choroidal thickness (CT).

SETTING

Tertiary university-based hospital.

DESIGN

Prospective nonrandomized comparative case series.

METHODS

Ninety-two eyes of 92 patients were assigned to the 3 groups after uneventful phacoemulsification: Group 1, dexamethasone; Group 2, ketorolac; Group 3, combined dexamethasone-ketorolac applied topically. CT at subfoveal (SFCT), nasal, and temporal as primary and central retinal thickness (CRT) as secondary outcomes were measured preoperatively and at 1 month, 3 months, and 6 months postoperatively using enhanced depth-imaging optical coherence tomography.

RESULTS

Preoperative CT was similar between the groups (all P > .05). The groups differed in pattern of changes in nasal and temporal CT (both P < .001) although their changes of CRT (P = .13) and SFCT (P = .55) over time were similar. The mean of SFCT at 1 month, 3 months, and 6 months was significantly higher than baseline in dexamethasone (P < .001 for all follow-ups) and combined (P < .001 for both 1 month and 3 months and P = .03 for 6 months) groups, whereas it was not statistically significant in the ketorolac group (P = .07). There was an increase in the nasal and temporal CT in 3 groups, persisted at 6 months in dexamethasone (both P < .001) and ketorolac (both P < .001) groups, whereas the change was not statistically significant at 6 months in the combined group. Choroidal thickness measurements were performed in 31 eyes of 31 patients in group 1, 29 eyes of 29 patients in group 2, and 32 eyes of 32 patients in group 3.

CONCLUSIONS

Dexamethasone and combined groups had statistically significant changes of SFCT after phacoemulsification; however, the ketorolac group did not. The pattern of SFCT changes was similar between 3 groups.

How does nepafenac affect the choroidal thickness after uneventful cataract surgery?

PURPOSE

To investigate the effects of topical nepafenac on choroidal thickness (CT) following uneventful phacoemulsification surgery (UPS) using enhanced depth imaging optical coherence tomography (EDI-OCT).

METHODS

This prospective study included 45 randomly selected eyes (23 eyes of 23 patients used nepafenac (nepafenac group) and 22 eyes of 22 control patients did not use nepafenac (nepafenac-free group)) undergoing small-incision UPS. All participants underwent full ophthalmologic examination. CT measurements were performed at subfoveal, 1.0 mm temporal, and 1.0 mm nasal using the EDI-OCT preoperatively, 1 day, 1 week, and 1 month postoperatively.

RESULTS

The mean subfoveal, nasal, and temporal CT in the nepafenac-free group had changed from 268.95 ± 63.59 μm to 283.36 ± 65.63 μm, 237.22 ± 64.09 μm to 253.09 ± 67.27 μm, and 235.95 ± 75.22 μm to 259.09 ± 63.66 μm preoperatively to 1 month postoperatively, respectively (p < 0.001, p < 0.001, p < 0.001, respectively). The mean subfoveal, nasal, and temporal CT in the nepafenac group had changed from 259.65 ± 55.99 μm to 276.65 ± 59.21 μm, 236.34 ± 55.40 μm to 251.00 ± 62.39 μm, and 247.56 ± 50.88 μm to 261.13 ± 53.73 μm preoperatively to 1 month postoperatively, respectively (p < 0.001, p < 0.001, p < 0.001, respectively). The postoperative CT continued to increase significantly during the follow-up period in two groups. However, compared to the change from baseline to month 1, there was not a statistically significant difference between the groups at subfoveal, nasal, and temporal CT (p: 0.633, p: 0.865, and p: 0.328, respectively).

CONCLUSION

UPS may cause a significant increase in CT. Although increasing in the CT was lower in the nepafenac group than the nepafenac-free group, there was not a statistically significant difference between the groups.

Changes in Ganglion Cell Complex and Peripapillary Retinal Nerve Fiber Layer after Femtosecond Laser-Assisted Cataract Surgery Compared to Manual Phacoemulsification in Patients Receiving a Trifocal Intraocular Lens

Introduction

During femtosecond laser-assisted cataract surgery (FLACS), there is a significant increase in intraocular pressure, which might lead to ganglion cell damage. We aimed to determine whether there were differences in the changes produced in the ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (pRNFL) thickness, as evaluated with optical coherence tomography (OCT), between phacoemulsification and FLACS, after implantation of a trifocal intraocular lens (IOL).

Methods

Patients with no coexistent pathologies undergoing cataract surgery with implantation of a PanOptix IOL were explored with the Cirrus-OCT before and three months after surgery. GCC values were obtained from the built-in software. The differences between pre- and postoperative GCC and pRNFL thicknesses after phacoemulsification were compared to differences after FLACS.

Results

A total of 171 eyes were included, 74 undergoing FLACS and 97 phacoemulsification. For both groups, there was a statistically significant increase in GCC values after cataract surgery, except for the inferior and inferonasal sectors. There were no statistically significant differences between FLACS and phacoemulsification. Mean change in average GCC and minimum GCC were 1.08 ± 1.40 µm (range −1 to +6 µm) and 1.69 ± 2.54 µm (range −3 to +11 µm) after FLACS and 0.99 ± 1.67 µm (range −5 to +6 µm) and 2.02 ± 3.54 µm (−6 to +18 µm) after phacoemulsification. These values are similar to those previously reported after phacoemulsification with monofocal IOL implantation. No significant changes after surgery were detected for the pRNFL, with no differences between groups. Discussion. There were no differences in the changes produced by FLACS and phacoemulsification in either GCC or pRNFL values. Although mean change was small, the range of variation was wide. Therefore, it is necessary to establish a new baseline for GCC and pRNFL thicknesses after cataract surgery in order to monitor any subsequent changes.

Phacoemulsification Induced Changes of Choroidal Thickness in Eyes with Age-Related Macular Degeneration

Background and Objectives: Patients with cataract and age-related macular degeneration (AMD) may safely undergo cataract phacoemulsification to enhance visual acuity. Although it has not been proven that cataract surgery can cause AMD progression, different phacoemulsification effects are observed not only on retinal but also on choroidal tissues. The purpose of this study was to evaluate the effect of phacoemulsification on the choroidal thickness (CT) in eyes with and without AMD. Materials and Methods: In 32 eyes of 32 patients with senile cataract (No-AMD group) and in 32 eyes of 32 patients with cataract and dry AMD (AMD group), who had phacoemulsification without intraoperative complications and intraocular lens implantation, foveal retinal thickness (FRT) and CT were evaluated three times: at 1–2 post meridiem preoperatively, then 1 month and 3 months postoperatively, using 1050 nm swept source-optical coherence tomography (Topcon, Tokyo, Japan). Results: In both groups, a significant increase in FRT was observed after one month and a decrease after three months without reaching the baseline. One month after surgery, a sectorial CT increase was apparent in all sectors in both groups. A negative association between CT and age was disclosed in the No-AMD group almost for all regions at all time points. Furthermore, CT was significantly negatively associated with axial length (AL) in all sectors at all time points in the AMD group. Conclusion: Uneventful phacoemulsification may induce changes in the posterior eye segment. An increase in CT and FRT was observed in both groups one month after the surgery. However, three months after surgery, CT changes were different in both groups, while FRT decreased in both groups. CT changes negatively associated with age in the No-AMD group and with AL in the AMD eyes. These postoperative changes in the choroid and retina may not only lead to the late-onset pseudophakic cystoid macular edema but also to progression of AMD.

[Effect of cataract extraction with intraocular lens implantation in patients with myopia on optical coherence tomography measurements]

INTRODUCTION

One important question for patients with both myopia and glaucoma is comparability of optical coherence tomography (OCT) data obtained before and after a significant change in eye refraction following cataract extraction surgery with implantation of intraocular lens (IOL).

PURPOSE

To assess the impact of correcting moderate and high myopia during cataract phacoemulsification with IOL implantation (Phaco/IOL) on the parameters measured by OCT.

MATERIAL AND METHODS

OCT was performed in 31 patients (31 eyes) with axial eye length of more than 25.5 mm before and the day after Phaco/IOL. Changes in 17 parameters of the retina, retinal ganglion cells-inner plexiform layer (GCIPL), peripapillary retinal nerve fiber layer (RNFL) and optic nerve head (ONH) were analyzed.

RESULTS

Axial eye length was 26.94±1.09 mm in average (25.57-29.39 mm). The average refractive effect of the intervention was 8.44±4.16 D (3.75-19.0 Diopters). Signal strength in all OCT protocols was no lower than 5. Changes in the average values of OCT parameters after surgery were insignificant. They exceeded 1% of the pre-operation values only in 7 cases, including all 5 parameters of the ONH, and were significant only in 5 out of 17 parameters. For GCIPL and RNFL thickness, the changes on average did not exceed 0.9 μm, for retinal thickness in the macular area - 2.1 μm. In relative terms, the largest decrease (an average of -0.03 mm²; -2.5%) was in the optic disc area.

CONCLUSION

In patients with high and moderate myopia, the parameters of the retina, RNFL, GCIPL, and ONH, as measured by OCT, changed insignificantly on the first day after Phaco/IOL (considering the signal strength of Cirrus HD-OCT device was not lower than 5).

Choroidal Thickness and Hemoglobin A1c Levels in Patients with Type 2 Diabetes Mellitus

Purpose

The aim of this study was to assess the correlation of hemoglobin A1c (HbA1c) levels with choroidal thickness in patients with type 2 diabetes mellitus (DM) using spectral domain optical coherence tomography (SD-OCT).

Methods

In this prospective case series, 180 eyes from 90 patients with type 2 DM were classified into three study groups based on HbA1c values: group 1 included patients with good glycemic control (HbA1c ≤ 7%), group 2 included patients with moderate glycemic control (HbA1c between 7% and 8%), and group 3 included patients with poor glycemic control (HbA1c ≥ 8%). Additionally, 50 eyes from 25 non-diabetic subjects were enrolled to group 4 as a control group. Sub-foveal, nasal, and temporal choroidal thickness were measured and compared.

Results

Mean central, nasal, and temporal choroidal thicknesses in diabetic patients (247.80, 238.63, and 239.30 μm) were significantly less than non-diabetic healthy subjects (277.56, 262.92, and 266.32 μm). Additionally, mean central, nasal, and temporal choroidal thickness values in group 4 (277.56, 262.92, and 266.32 μm) were significantly greater than the corresponding values in group 2 (248.34, 237.55, and 236.45 μm) and group 3 (239.81, 234.62, and 233.94 μm), but was not significantly different from corresponding values in group 1 (259.46, 246.12, and 251.00 μm).

Conclusion

HbA1c values have a significant correlation with choroidal thickness in diabetic patients, and better glycemic control with HbA1c ≤ 7% may prevent choroidal thinning.

Effect of femtosecond laser-assisted lens surgery on the optic nerve head and the macula

AIM

To evaluate the effect of femtosecond laser-assisted lens surgery (FLALS; cataract surgery or refractive lens exchange) on the structure of the optic nerve head and the macula.

METHODS

This prospective longitudinal study included healthy eyes undergoing FLALS. Eyes with glaucoma or any other ocular disease that could alter optical coherence tomography results were excluded. Retinal nerve fiber layer (RNFL), Bruch's membrane opening-minimum rim width (BMO-MRW) and macular thickness (MT) were measured preoperatively, 1 and 6mo after surgery using spectral-domain optical coherence tomography (SD-OCT). Changes between preoperative and postoperative values were evaluated.

RESULTS

A total of 87 eyes of 46 patients were included in this study. Preoperative RNFL, BMO-MRW and MT in microns (µm) were 100.77±10.39, 330.31±49.99 and 276.30±33.39, respectively. Postoperative RNFL, BMO-MRW and MT were 104.74±11.55, 348.32±54.05 and 279.83±22.65 1mo after surgery and 102.93±11.17, 343.11±53.4 and 278.90±22.19 6mo after surgery, respectively; which equals an increase of 3.93%, 5.45% and 1.27%, respectively, 1mo after surgery, and 2.14%, 3.87% and 0.94% 6mo after surgery. The differences between the preoperative and the postoperative RNFL and BMO-MRW values were statistically significant (P<0.001). Regarding MT values, there were not statistically significant differences (P=0.26).

CONCLUSION

Our study suggests that FLALS does not have a negative impact on the structural status of the optic nerve head in healthy eyes, assessed by SD-OCT. There is a slight increase in the values of RNFL, BMO-MRW and MT 1mo and 6mo after surgery.

Changes of Subfoveal Choroidal Thickness after Cataract Surgery: A Meta-Analysis

Purpose

To investigate the effect of cataract surgery on subfoveal choroid thickness (SFCT) using enhanced-depth imaging optical coherence tomography (EDI-OCT).

Materials and Methods

Relevant publications were searched systematically through various databases from inception to March 2018. The unit of choroidal thickness measurements is micrometers. Studies comparing SFCT before and after cataract surgery were retrieved. All qualified articles were analyzed using RevMan 5.3.

Results

A total of 13 studies with 802 eyes from 646 patients were identified for inclusion. There was a significant increase of SFCT at 1 week (MD = 6.62, 95% CI: 1.20-12.05, P=0.02, I² = 0%), 1 month (MD = 8.30, 95% CI: 3.20-13.39, P=0.001, I² = 0%), and 3 months (MD = 8.28, 95% CI: 1.84-14.73, P=0.01, I² = 0%) after cataract surgery. In subgroup analysis, SFCT in Asians and patients without nonsteroidal anti-inflammatory drugs (NSAIDs) in postoperative medication was significantly thicker (P < 0.05). No statistically significant increase of SFCT was found in diabetic mellitus (DM) patients for 1 day (P=0.89), 1 week (P=0.59), 1 month (P=0.52), and 3 months (P=0.42) after cataract surgery.

Conclusions

This meta-analysis suggested that SFCT increased since 1 week after the cataract surgery and the increase lasted for at least 3 months. Asians and patients without NSAIDs in postoperative medication were more likely to have a thicker SFCT after cataract surgery, whereas DM patients were less likely to increase in SFCT.

Choroidal thickness changes following cataract surgery in patients with type 2 diabetes mellitus

Purpose

To evaluate the choroidal thickness changes after cataract surgery in type 2 diabetic patients.

Methods

Three groups of patients were enrolled into this prospective study. Group A included diabetic patients without diabetic retinopathy (DR) or with mild non-proliferative diabetic retinopathy (NPDR) who underwent phacoemulsification, Group B included non-diabetic patients with significant cataract who underwent phacoemulsification, and Group C included diabetic patients without DR or with mild NPDR who followed up without surgical procedure. Choroidal thickness in 5 points (subfoveal and 500 μ temporal, nasal, superior and inferior to the fovea) and central macular thickness were measured before surgery using enhanced depth spectral domain optical coherence tomography. Patients were re-evaluated 1 week, 1 month, and 3 months after operation and compared with the baseline values.

Results

In total, 63 eyes from 63 patients were enrolled to this study, including 21 eyes in Group A, 22 eyes in Group B, and 20 eyes in Group C. After three months of follow-up of the patients, choroidal thickness in all measured points was decreased significantly, and central macular thickness was increased significantly following cataract surgery in diabetic eyes (Ggroup A); meanwhile, both choroidal thickness and central macular thickness were increased significantly in non-diabetic eyes (Group B). In Group C, choroidal thickness and central macular thickness had no significant changes, after three months.

Conclusion

Unlike in non-diabetic eyes, choroidal thickness in diabetic patients decreased following cataract surgery.

Effect of infusion pressure during cataract surgery on ganglion cells measured using isolated-check visual evoked potential

AIM

To detect the relationship between infusion pressure and postoperative ganglion cells function.

METHODS

This prospective observational cohort study included sixty-one eyes that underwent uncomplicated cataract surgery. Patients were divided into two groups according to infusion time (IT) recorded using surgery equipment [Group A: IT>IT_mean (27 eyes); Group B: IT<IT_mean (34 eyes)]. Best-corrected visual acuity, isolated-check visual evoked potential (icVEP), microperimetry, and optical coherence tomography examinations were performed preoperatively and 1wk and 1mo postoperatively. The changes in test results were measured with independent-sample t-tests and paired t-tests. Correlation between IT and these changes were analyzed with Pearson's correlation analysis and Spearman correlation analysis.

RESULTS

Neither group showed significant postoperative changes in macular ganglion cell-inner plexiform layer (mGC-IPL) thickness (1-week postoperative: Group A P=0.185, Group B P=0.381; 1-month postoperative: Group A P=0.775, Group B P=0.652). Postoperative mGC-IPL thickness of Group A was not significantly thicker than that of Group B at both post surgery time point (1-week postoperative P=0.913; 1-month postoperative P=0.954). In Group A, the mGC-IPL thickness change 1wk postoperatively was positively correlated with IT (R²=0.156, P=0.0198). A suspected progressive deficit in the magnocellular pathway was also found in Group A 1-month postoperatively [individual observed F (IOF)=0.63±0.70]. Significant increases were observed in postoperative retinal sensitivity measured by microperimetry (1-week postoperative: Group A P=0.015, Group B P<0.001; 1-month postoperative: Group A P=0.005, Group B P<0.001). In Group B, IT was negatively correlated with the increase in macular sensitivity (1-week postoperative: R²=0.372, P<0.001; 1-month postoperative: R²=0.209, P=0.007).

CONCLUSION

Both mGC-IPL thickness and retinal sensitivity increased postoperatively. A suspected progressive deficit in the magnocellular pathway was found in the group with a long IT, which induced more prominent changes.