Association between systemic immune-inflammation index and postoperative optical quality in the early recovery phase...

Early postoperative optical quality varies among patients after cataract surgery. Systemic inflammation is increasingly recognized as a factor influencing postoperative recovery. This study aimed to investigate the association between preoperative systemic immune-inflammation index (SII), defined as neutrophil count × platelet count / lymphocyte count, and early objective optical quality following phacoemulsification cataract surgery.

This retrospective study included 110 eyes of 110 patients who underwent uneventful phacoemulsification with monofocal intraocular lens implantation. The primary outcome for this analysis was internal modulation transfer function (MTF) average height, total-eye MTF average height and corneal MTF average height were treated as secondary outcomes. Linear mixed-effects models with mean-centered log2-SII were used to analyze the relationship between SII and MTF average height. Exploratory analyses included Strehl ratio (SR), higher-order aberrations (HOAs), dysfunctional lens index (DLI) and objective scatter index (OSI). Intergroup differences were compared at each postoperative time point.

Higher preoperative log2-SII was significantly associated with lower internal MTF average height at postoperative 1 week (β = -0.042, 95%CI: -0.069 to -0.015, P = 0.002) and 1 month (β = -0.039, 95%C: -0.066 to -0.013, P = 0.004), but not at 1 day (P = 0.299). The log2-SII* time interaction was significant at 1 week (P = 0.032) and borderline at 1 month (P = 0.043). No consistent associations were found for total-eye or corneal MTF. In exploratory analyses (median-split), the low-SII group showed better internal Strehl ratio at 1 week and 1 month, lower total higher-order aberrations and secondary astigmatism at 1 month, as well as higher dysfunctional lens index and lower objective scatter index at 1 month (all P < 0.05). Postoperative visual acuity did not differ between groups at any time point (P > 0.05).

Higher preoperative SII was associated with less favorable early postoperative internal MTF average height. Exploratory analyses suggested potential differences in SR, HOAs, DLI, and OSI, but these findings require confirmation in future studies. Despite comparable visual acuity, systemic inflammatory status may contribute to interindividual variability in early optical recovery after cataract surgery.