Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography...

Area of Science:

• Ophthalmology
• Vascular Biology
• Medical Imaging

Background:

• Age-related cataracts are a leading cause of global blindness.
• Phacoemulsification is the standard surgical intervention for cataracts.
• Optical coherence tomography angiography (OCTA) offers non-invasive assessment of microvascular changes.

Purpose of the Study:

• To systematically review vascular changes in the macula and optic nerve post-phacoemulsification using OCTA.
• To synthesize findings from existing literature on OCTA-assessed microvascular alterations after cataract surgery.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Searched Scopus, PubMed, and Web of Science databases (2015-June 2025).
• Assessed study quality using NHLBI tools; 21 studies included.

Main Results:

• Most studies reported increased vascular density in various retinal plexuses.
• A reduction in the foveal avascular zone (FAZ) was commonly observed.
• Observed changes varied by retinal region, plexus, and follow-up duration.

Conclusions:

• Phacoemulsification is associated with increased vascular density and reduced FAZ.
• Post-operative inflammation, decreased intraocular pressure (IOP), and increased retinal metabolism may contribute to these changes.
• Patient-specific factors like diabetes and myopia influence vascular response variability.