Clinical Study Of Macular Central Sulcus Retinal And Choroidal Thickness Changes In Highly Myopic Cataract Patients After Ultrasound Emulsification

Objective:In this study,optical coherence tomography(OCT)was used to observe the changes in central retinal thickness(CRT)and subfoveal choroidal thickness(SFCT)in highly myopic and non-highly myopic cataract patients before and after ultrasound emulsion aspiration surgery and the factors affecting them.Methods:Seventy patients(83 eyes)with cataract who attended the Nanchang University Eye Hospital from August 2021 to November 2022 and underwent cataract ultrasound emulsification combined with IOL implantation were selected.All patients were divided into 2 groups according to the length of the eye axis: 38 cases and 43 eyes in the non-hyperopic group with an eye axis length of 22～26 mm and 32 cases and 40 eyes in the hyperopic group with an eye axis length of ≥26 mm.The CRT,SFCT,best corrected visual acuity(BCVA)and axial length were measured and recorded using an optical coherence tomography scanner at different times before and after surgery.SPSS 25.0 was used for statistical analysis of all data.Results:1.The differences in age,uncorrected visual acuity(UCVA)and BCVA between the high myopia group and the non-high myopia group were not statistically significant(P>0.05).2.BCVA: The BCVA in the high myopia group was slightly lower than that in the non-high myopia group,and the BCVA in both groups increased to different degrees at 3 months after surgery compared to the preoperative level,and there was a statistically significant difference between the two groups(P< 0.05).CRT: In both groups,the thickening of the CRT occurred at 1 week after surgery,peaked at 1month,and began to decrease at 3 months after surgery,but was still higher than the preoperative level,with an important difference in terms of statistical significance(P < 0.05).Statistically significant differences were found between the two groups(P< 0.05)in that the retinal thickness of the central macular sulcus was reduced at all postoperative times in the highly myopic group compared to the non-highly myopic group.SFCT: In both groups,the postoperative SFCT increased at all time points compared to the preoperative SFCT,with statistically significant(P < 0.05).Differences between the two groups were statistically significant(P < 0.05),as the postoperative SFCT was lower in the highly myopic group than in the non-highly myopic group.3.Bivariate correlation analysis: preoperative CRT and postoperative BCVA were positively correlated in the high myopia group(P<0.05),while preoperative CRT and postoperative BCVA were not correlated in the non-high myopia group(P>0.05);Preoperative and 3-month postoperative SFCT was significantly negatively correlated with age and eye axis length in both groups(P<0.05),while CRT was not correlated with age and eye axis length(P > 0.05).Conclusion:1.The preoperative CRT and SFCT were significantly thinner in highly myopic cataract patients,and the postoperative CRT and SFCT increased at all time points compared to the preoperative period,while the postoperative CRT and SFCT were significantly lower at 3 months than at 1 week and 1 month postoperatively,but higher than preoperatively.2.Preoperative CRT in highly myopic cataract patients was associated with postoperative BCVA and was predictive of the patient’s postoperative visual acuity.Also SFCT was negatively correlated with age and eye axis length.