Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany.
Klin Monbl Augenheilkd. 2023 Aug;240(8):989-996. doi: 10.1055/a-2120-7415. Epub 2023 Aug 11.
Due to its invasive nature, cataract surgery can lead to inflammatory processes in the posterior segment, which can result in prolonged recovery times, reduced functional outcomes, and late-onset complications. The aim of the current study was to identify wherever phacoemulsification parameters play a role in choroidal thickness change following cataract surgery.
This prospective single-center study enrolled 31 patients (31 eyes) scheduled to undergo routine cataract surgery. Patients with previous ocular surgeries, pathologies or general disorders affecting vision were excluded. Patients were examined preoperatively, as well as 1, 4, and 12 weeks after surgery. Corrected distance visual acuity (CDVA), intraocular pressure (IOP) as well as cumulative dissipated energy (CDE), ultrasound time (UT), and fluids used during surgery were recorded. Subfoveal choroidal thickness was measured manually by two masked independent experts using enhanced depth imaging (EDI) optical coherence tomography (OCT). Furthermore, cataract density was automatically calculated using a custom MATLAB script and an anterior segment OCT.
Subfoveal choroidal thickness increased significantly (p < 0.001, Student's paired sample t-test) and continuously during the 12-week-long follow-up period. Both the nuclear lens density and the improvement in CDVA correlated significantly with this increase (r = 0.413, p = 0.021 and r = 0.421, p = 0.018, respectively). Neither the CDE (r = 0.334, p = 0.071), the UT (r = 0.102, p = 0.629), the amount of fluid used (r = 0.237, p = 0.27) nor the decrease in IOP (r = - 0.197, p = 0.288) showed any significant correlation with the choroidal swelling.
Cataract surgery leads to an increase in subfoveal choroidal thickness. While no statistically significant correlation to the phacoemulsification parameters could be established, this might be because of a selection bias due to the technological constraints of the OCT. Nevertheless, the choroid might play a central role in early- and late-onset complications.
由于其侵袭性，白内障手术可导致后节的炎症过程，从而导致恢复时间延长、功能结果降低和迟发性并发症。本研究的目的是确定白内障手术后脉络膜厚度变化中 phacoemulsification 参数的作用。
本前瞻性单中心研究纳入了 31 名（31 只眼）计划接受常规白内障手术的患者。排除了有先前眼部手术、病变或影响视力的一般疾病的患者。患者在术前以及术后 1、4 和 12 周进行检查。记录矫正远视力（CDVA）、眼内压（IOP）以及累积耗散能量（CDE）、超声时间（UT）和手术中使用的液体。两名经过训练的独立专家使用增强深度成像（EDI）光学相干断层扫描（OCT）手动测量中心凹下脉络膜厚度。此外，使用定制的 MATLAB 脚本和前节 OCT 自动计算白内障密度。
在 12 周的随访期间，中心凹下脉络膜厚度显著增加（p<0.001，学生配对样本 t 检验）且呈持续增加趋势。核晶状体密度和 CDVA 的改善与这种增加显著相关（r=0.413，p=0.021 和 r=0.421，p=0.018）。CDE（r=0.334，p=0.071）、UT（r=0.102，p=0.629）、使用的液体量（r=0.237，p=0.27）或 IOP 降低（r=−0.197，p=0.288）均与脉络膜肿胀无显著相关性。
白内障手术导致中心凹下脉络膜厚度增加。虽然与 phacoemulsification 参数没有建立统计学显著相关性，但这可能是由于 OCT 技术限制造成的选择偏倚。然而，脉络膜可能在早发和迟发性并发症中发挥核心作用。
