Evaluation of peripapillary retinal nerve fiber thickness and macular changes before and after phacoemulsification

Session Details

Session Title: Cataract
Session Date/Time: Saturday 10/02/2018 | 08:30-11:00
Paper Time: 08:36
Venue: Blue Hall

First Author: M.Aly zaky EGYPT
Co Author(s): R. Zazaa  H. Saleh              

Abstract Details

Purpose:

Phacoemulification is the most common technique used for cataract surgery. ultrasonic energy and fluidics produce inflammatory reaction that lead to cystoid macular edema. Our study is about assessment of the effect of phacoemulsification on the retinal nerve fiber layer and macular thickness compared to peroperative thickness. Assessment of the correlation between phaco time and the macular thickness changes after surgery.

Setting:

Ophthalmology Department, Faculty of Medicine, Menoufia University- Egypt

Methods:

The study includes 50 eyes of 50 patients who underwent phacoemulsification. The phaco time was estimated during the operation. Retinal nerve layer thickness and macular thickness were measured one day before phaco and one week postoperatively respectively, using the spectral domain Optical Coherence Tomography at the ophthalmology department clinic at Menoufia University hospital.

Results:

The retinal nerve fiber layer thickness average was 96.52 µm (SD ± 12.00), 101.28 µm (SD ± 11.87), 111.96 µm (SD ± 11.43), one day before cataract surgery, one week postoperative and one month postoperative respectively. we found that the central retinal nerve fiber thickness measurements one week and one month postoperatively were significantly higher than those measured preoperatively (P<0.001). The average central macular thickness was 230.58µm (SD ±25.46), 259.22 µm (SD± 25.44), 271.12 µm (SD± 24.62) one day preoperative, one week postoperative and one month postoperative respectively. A statistically significant increase in the central macular was elicited in the 1st week and 1st month postoperatively than preoperative (P<0.001). this increase in the macular thickness was significant in all 9 areas of the macula (P<0.001). The increase in macular thickness is positively correlated to the phaco time after 1st week (P<0.001) and 1st month of phaco (P<0.001)

Conclusions:

Phacoemulsification leads to a significant increase in the central retinal nerve fiber thickness and in nine macular area thickness after one week and one month of phacoemulsification than preoperatively. These results support the concept that the ultrasound of phaco leads to an inflammatory reaction causing macular edema and the removal of the opacified media improves the transimmittance and reflectivity of the retinal nerve fiber boundary, resulting in increases of the RNFL thickness after phaco.

Financial Disclosure:

None