Analysis Of Choroidal And Retinal Thickness After Phacoemulsification Combined With Intraocular Lens Implantation

Objective: Evaluate the changes of each retinal layer in the macular area and choroidal thickness in the early stages after phacoemulsification combined with intraocular lens implantation surgery.Methods: A prospective case analysis was performed from April 2017 to November 2019.22 patients with age related cataract diagnosed in the First Affiliated Hospital of China Medical University was treated with phacoemulsification surgery and IOL implantation(PEA + IOL).All patients underwent enhanced depth imaging optical coherence tomography(EDI-OCT)examination pre-operatively and postoperatively 1day,1week,1 month,and measured the average thickness of each retinal layer and subfoveal choroidal thickness.Results: A total of 22 patients,24 eyes were enrolled in this study,including 9 males 10 eyes,13 females 14 eyes.Cataract stage 3 in 5 eyes,cataract stage 4 in 18 eyes,cataract stage 5 in 1 eye.Preoperative BCVA was 0.28±0.17,and 0.80±0.21 at 1 day postoperatively.At 1month after surgery the retinal thickness in macular area was 314.02±20.40 mm,which was significantly higher than the baseline 288.27±30.58mm,difference was statistically significant(p=0.001).In addition,compared with baseline Inner Retinal Layer thickness increased significantly at 1week and 1 month after surgery(1week after surgery: 222.49±15.57 mm,p<0.001;1month after surgery: 235.78±20.10 mm p<0.001).In contrast,the thickness of Outer Retinal Layer thickness decreased significantly at 1 week and 1 month after surgery(1week after surgery: 78.55±2.16mm,p<0.01;1 month after surgery: 79.24±2.95 mm,p<0.02).The thickness of Nerve Fiber layer at 1 week and 1 month after surgery was 27.68±3.27mm and 32.31±7.60mm,which were significantly higher than the baseline 26.92±3.94mm(1 week p=0.002;1 month: p<0.001).The thickness of the Ganglion Cell Layer at 1 week and 1 month after surgery was 38.49±3.88mm and 39.81±4.47mm respectively,which was significantly higher than the baseline at 35.48±4.59mm(p<0.001).The thickness of Inner Plexiform Layer was 32.71±2.70mm and 34.26±3.09mm at 1week and 1month after surgery,which were significantly higher than the baseline at 31.51±2.89mm(p<0.001).The thickness of the Outer Nuclear Layer increased significantly only at 1 month postoperatively(baseline: 57.79±8.52 mm;1month: 63.87±9.53mm p<0.001).However,Subfoveal choroidal thickness was at baseline(221.8±95.42mm),1 day after surgery(218±95.23mm),1 week after surgery(227.63±91.92 mm)and 1 month after surgery(217.25±98.98mm).No statistical significance was found(p>0.05).Conclusion: Phacoemulsification combined with intraocular lens implantation can increase the thickness of macular area retina,inner retinal layer,retinal nerve fiber layer,ganglion cell layer and inner plexiform layer,increase the thickness of outer nuclear layer,decrease the thickness of outer retinal layer,and not cause choroidal changes in early stage.