Assessment of Microvascular Changes using Optical Coherence Tomography Angiography after Phacoemulsification Surgery in an Indian Population

S. Dabir, Mohan Rajan, Sujatha Mohan, Vaidehi Bhatt, M. Ravishankar, Sowmya Sunil, Deepak Bhatt, Preetam Samant, Tos Berendschot, Carroll Webers

Research output: Contribution to journalArticleAcademic


Purpose: To identify changes in superficial retinal capillary microvasculature before and after cataract surgery using
optical coherence tomography angiography (OCTA).
Setting: Rajan eye care, Tertiary care center in Chennai, India.
Design: Prospective observational study.
Methods: Patients above 40 years who underwent uncomplicated cataract surgery had 6 × 6 mm OCTA foveacentered scans using Zeiss Angioplex 5000 OCTA before and 4 weeks postoperatively. Signal strength and automated
values obtained for perfusion density (PD) and vascular density (VD) were recorded.
Results: Fifty-eight eyes of 33 patients aged 67 ± 5 years were enrolled. Signal strength (3.9 ± 2.3 vs. 5.7 ± 2.1,
p<0.001), PD (16.4 ± 10.4 vs. 26.6 ± 10.3, p<0.001) and VD (7.4 ± 4.5 vs. 11.4 ± 4.0, p<0.001) increased significantly
after surgery. Strong positive correlation was seen between signal strength and PD (r=0.86, p<0.001) and VD (r=0.79,
p<0.001). Linear mixed model analysis with eye as grouping factor, time (i.e. pre and post-surgery) and signal strength
as covariates showed, surgery independently caused an increase in PD (ß=3.63 increment in PD after surgery,
p<0.001) and VD (ß=1.61 increment in VD after surgery, p=0.003). After adjusting for signal strength, a 20%
increment in macular PD and VD was observed in central 1 mm area around fovea. Foveal avascular zone (FAZ) area,
perimeter and circularity, did not change after surgery.
Conclusion: Macular perfusion and vascularity indices increase immediately after cataract surgery independent of
improvement in signal strength, though FAZ is not influenced.
Original languageEnglish
Article number1000002
Number of pages6
JournalJournal of Clinical and Experimental Ophthalmology
Issue numberS8
Publication statusPublished - 2021

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