A Meta-Analysis of Changes in the Retinal Thickness and Vasculature after Phacoemulsification Surgery

Abstract

Background Phacoemulsification is the most popular cataract surgery nowadays. However, phacoemulsification provokes discharge of pro-inflammatory molecules not only affecting the anterior but also posterior eye segments. Aim of the Work the aim of the study was to evaluate through the available literature the correlation between cumulative dissipated energy and total ultrasound time in one hand, and retinal thickness and vasculature in the other hand after phacoemulsification surgery through systematic review and meta-analysis. Subjects and methods This meta-analysis study included randomized controlled trials and retrospective or prospective observational studies evaluating the correlation between cumulative dissipated energy, and total ultrasound time and retinal thickness and vasculature after phacoemulsification surgery. In this systematic review a thirty studies were included in the period from 2006 to 2020 with 29 prospective studies and one Quasiexperimental study. Results The mean preoperative central foveal retinal thickness (μm) was 232.6±25.8(μm) and increased to 243.66±29.2(μm) Postoperatively. Mean preoperative average RNFL thickness was 89±10.2 (μm) and increased to 96.6±10.0 (μm) postoperatively. mean GCL thickness (μm) was 80.56±60(μm) preoperatively and increased to 84.74±7.20(μm) postoperatively. parafoveal perfusion density percentage was 0.28% pre-operative and increased post- operative to be 0.29%, the pre-operative perifoveal perfusion density percentage was 0.45% which increased post-operatively to be 0.53%, the pre-operative peripapillary perfusion density percentage value was 0.49% which increased to 0.53% post operatively. Conclusion the retinal vessel density and vascular perfusion were found to be increased significantly in both macular and peripapillary areas p = 0.003. This increase was accompanied with changes of retinal layer thickness p = 0.00001.