Evaluation of Microvascular Changes in the Macula After Uneventful Phacoemulsification Surgery Using Optical Coherence Tomography Angiography.

STUDY DESIGN: This was a longitudinal observational study. PURPOSE: The purpose of this study was to evaluate whether there are microvascular changes in the retina after uneventful phacoemulsification surgery using optical coherence tomography angiography (OCTA) under topical anesthesia. METHODS: OCTA scans of the 3 mm × 3 mm macula were obtained in 53 eyes to measure the superficial capillary perfusion (SCP) vessel density, perfusion density, foveal avascular zone (FAZ) area, perimeter, circularity, and central subfield thickness (CST) at the pre-operative visit and at one week and one month following phacoemulsification surgery under topical anesthesia in an Indian population. RESULTS: There was a statistically significant increase in SCP vessel density at one week (17.604 ± 3.3340) and one month (18.725 ± 2.8280) post-operatively compared with the pre-operative visit (16.017 ± 3.6574) (P < 0.001). Similarly, a statistically significant increase was found in SCP perfusion density at one week (33.079 ± 4.8540) and one month (34.585 ± 4.1916) post-operatively compared with the pre-operative visit (30.285 ± 5.6133) (P < 0.001). However, no significant changes in the FAZ or CST parameters were found post-operatively. CONCLUSION: The findings suggest that phacoemulsification may influence retinal microcirculation without causing significant structural macular changes. This study adds to the growing body of evidence regarding retinal microvascular alterations after cataract surgery and highlights the utility of OCTA as a non-invasive tool for evaluating post-operative retinal vascular changes.