Skip to main content

Optic nerve head microvascular changes after phacoemulsification surgery

Graefe's Archive for Clinical and Experimental Ophthalmology volume 257, pages 2729–2733 (2019)Cite this article

Abstract

Background

To determine optic nerve head (ONH) microvascular changes detected by optical coherence tomography angiography (OCTA) and intraocular pressure changes (IOPs) after uncomplicated phacoemulsification surgery.

Methods

The study was designed as a prospective observational study. Twenty-four eyes were included. Eyes with retinal vascular pathology, any type of age-related macular degeneration, IOP more than 21 mmHg, axial length less than 20 mm and more than 24 mm, corneal edema and cataracts that can disrupt images, and history of ocular surgery were excluded. Patients underwent OCTA imaging and IOP measurement preoperatively (baseline) and postoperatively (weeks 1 and 4). Vessel density % (VD) in the total disc, peripapillary, and inside disc were measured. IOP was measured with the applanation tonometer. Comparison of VD and IOP and correlation between VD and İOP change were determined.

Results

VD was significantly increased in all quadrants in week 4 compared to those in week 1. In terms of VD and IOP, although there was no significant difference between week 1 and baseline, week 4 results were significantly different from baseline (p < 0.05 and p < 0.001, respectively). The IOP was significantly lower in week 4 (14.8 mmHg) than in week 1 (16.0 mmHg) (p < 0.001). There was a significant negative correlation between the inside disc and total VD and IOP at weeks 1 and 4.

Conclusion

Phacoemulsification surgery can result in a decrease in IOP and an increase in VD of the ONH.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Melancia D, Abegao Pinto L, Marques-Neves C (2015) Cataract surgery and intraocular pressure. Ophthalmic Res 53:141–148. https://doi.org/10.1159/000377635

    Article  PubMed  Google Scholar 

  2. Hilton EJ, Hosking SL, Gherghel D, Embleton S, Cunliffe IA (2005) Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics. Eye (London, England) 19:670–675. https://doi.org/10.1038/sj.eye.6701620

    CAS  Article  Google Scholar 

  3. Wylegala A, Teper S, Dobrowolski D, Wylegala E (2016) Optical coherence angiography: a review. Medicine 95:e4907. https://doi.org/10.1097/md.0000000000004907

    Article  PubMed  PubMed Central  Google Scholar 

  4. Spaide RF, Fujimoto JG, Waheed NK, Sadda SR, Staurenghi G (2018) Optical coherence tomography angiography. Prog Retin Eye Res 64:1–55. https://doi.org/10.1016/j.preteyeres.2017.11.003

    Article  PubMed  Google Scholar 

  5. Schmidl D, Boltz A, Kaya S, Werkmeister R, Dragostinoff N, Lasta M, Polska E, Garhofer G, Schmetterer L (2012) Comparison of choroidal and optic nerve head blood flow regulation during changes in ocular perfusion pressure. Invest Ophthalmol Vis Sci 53:4337–4346. https://doi.org/10.1167/iovs.11-9055

    Article  PubMed  Google Scholar 

  6. Guidoboni G, Harris A, Cassani S, Arciero J, Siesky B, Amireskandari A, Tobe L, Egan P, Januleviciene I, Park J (2014) Intraocular pressure, blood pressure, and retinal blood flow autoregulation: a mathematical model to clarify their relationship and clinical relevance. Invest Ophthalmol Vis Sci 55:4105–4118. https://doi.org/10.1167/iovs.13-13611

    Article  PubMed  PubMed Central  Google Scholar 

  7. Flammer J, Orgul S, Costa VP, Orzalesi N, Krieglstein GK, Serra LM, Renard JP, Stefansson E (2002) The impact of ocular blood flow in glaucoma. Prog Retin Eye Res 21:359–393

    Article  Google Scholar 

  8. Shiose Y, Kitazawa Y, Tsukahara S, Akamatsu T, Mizokami K, Futa R, Katsushima H, Kosaki H (1991) Epidemiology of glaucoma in Japan--a nationwide glaucoma survey. Jpn J Ophthalmol 35:133–155

    CAS  PubMed  Google Scholar 

  9. Flammer J, Orgul S (1998) Optic nerve blood-flow abnormalities in glaucoma. Prog Retin Eye Res 17:267–289

    CAS  Article  Google Scholar 

  10. Langham ME, Farrell RA, O'Brien V, Silver DM, Schilder P (1989) Blood flow in the human eye. Acta ophthalmol Suppl 191:9–13

    CAS  PubMed  Google Scholar 

  11. Pekel G, Acer S, Cetin EN, Yagci R, Kasikci A, Cevik A (2015) Ocular pulse amplitude and retinal vessel caliber changes after intravitreal ranibizumab. Int Ophthalmol 35:657–662. https://doi.org/10.1007/s10792-014-9991-z

    Article  PubMed  Google Scholar 

  12. Matthiessen ET, Zeitz O, Richard G, Klemm M (2004) Reproducibility of blood flow velocity measurements using colour decoded Doppler imaging. Eye (London, England) 18:400–405. https://doi.org/10.1038/sj.eye.6700651

    CAS  Article  Google Scholar 

  13. Hayreh SS (1972) Colour and fluorescence of the optic disc. Ophthalmologica 165:100–108. https://doi.org/10.1159/000308475

    CAS  Article  PubMed  Google Scholar 

  14. Riva CE (2001) Basic principles of laser Doppler flowmetry and application to the ocular circulation. Int Ophthalmol 23:183–189

    CAS  Article  Google Scholar 

  15. Sugiyama T, Araie M, Riva CE, Schmetterer L, Orgul S (2010) Use of laser speckle flowgraphy in ocular blood flow research. Acta Ophthalmol 88:723–729. https://doi.org/10.1111/j.1755-3768.2009.01586.x

    Article  PubMed  Google Scholar 

  16. Sehi M (2011) Basic technique and anatomically imposed limitations of confocal scanning laser Doppler flowmetry at the optic nerve head level. Acta Ophthalmol 89:e1–e11. https://doi.org/10.1111/j.1755-3768.2009.01728.x

    Article  PubMed  Google Scholar 

  17. Prunte C, Flammer J, Markstein R, Rudin M (1995) Quantification of optic nerve blood flow changes using magnetic resonance imaging. Invest Ophthalmol Vis Sci 36:247–251

    CAS  PubMed  Google Scholar 

  18. Wang Y, Bower BA, Izatt JA, Tan O, Huang D (2008) Retinal blood flow measurement by circumpapillary Fourier domain Doppler optical coherence tomography. J Biomed Opt 13:064003. https://doi.org/10.1117/1.2998480

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jia Y, Tan O, Tokayer J, Potsaid B, Wang Y, Liu JJ, Kraus MF, Subhash H, Fujimoto JG, Hornegger J, Huang D (2012) Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express 20:4710–4725. https://doi.org/10.1364/oe.20.004710

    Article  PubMed  PubMed Central  Google Scholar 

  20. Hopkins SD (1989) Ocular haemodynamics in cataractous eyes. A pilot study. Acta ophthalmol Suppl 191:43–48

    CAS  PubMed  Google Scholar 

  21. ALP MN, DOĞAN B, TOLA M, YARANGÜMELİ A, ÖLÇER T, KURAL G (2004) Effect of cataract surgery on orbital blood flow in diabetic patients with nonproliferative retinopathy. Journal of Retina-Vitreous 12:189–194

    Google Scholar 

  22. Turk A, Mollamehmetoglu S, Imamoglu HI, Kola M, Erdol H, Akyol N (2013) Effects of phacoemulsification surgery on ocular hemodynamics. Int J Ophthalmol 6:537

    PubMed  PubMed Central  Google Scholar 

  23. Rainer G, Kiss B, Dallinger S, Menapace R, Findl O, Schmetterer K, Georgopoulos M, Schmetterer L (1999) Effect of small incision cataract surgery on ocular blood flow in cataract patients1. J Cataract Refract Surg 25:964–968

    CAS  Article  Google Scholar 

  24. Zhao Z, Wen W, Jiang C, Lu Y (2018) Changes in macular vasculature after uncomplicated phacoemulsification surgery: optical coherence tomography angiography study. J Cataract Refract Surg 44:453–458. https://doi.org/10.1016/j.jcrs.2018.02.014

    Article  PubMed  Google Scholar 

  25. Mathalone N, Hyams M, Neiman S, Buckman G, Hod Y, Geyer O (2005) Long-term intraocular pressure control after clear corneal phacoemulsification in glaucoma patients. J Cataract Refract Surg 31:479–483. https://doi.org/10.1016/j.jcrs.2004.06.046

    Article  PubMed  Google Scholar 

  26. Poley BJ, Lindstrom RL, Samuelson TW (2008) Long-term effects of phacoemulsification with intraocular lens implantation in normotensive and ocular hypertensive eyes. J Cataract Refract Surg 34:735–742. https://doi.org/10.1016/j.jcrs.2007.12.045

    Article  PubMed  Google Scholar 

  27. Shrivastava A, Singh K (2010) The effect of cataract extraction on intraocular pressure. Curr Opin Ophthalmol 21:118–122. https://doi.org/10.1097/ICU.0b013e3283360ac3

    Article  PubMed  Google Scholar 

  28. Shingleton BJ, Pasternack JJ, Hung JW, O'Donoghue MW (2006) Three and five year changes in intraocular pressures after clear corneal phacoemulsification in open angle glaucoma patients, glaucoma suspects, and normal patients. J Glaucoma 15:494–498. https://doi.org/10.1097/01.ijg.0000212294.31411.92

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Ophthalmology, Mugla Sıtkı Koçman University Medical School, Mugla, Turkey

    Müjdat Karabulut, Sinem Karabulut, Sabahattin Sül & Aylin Karalezli

Authors
  1. Müjdat Karabulut
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sinem Karabulut
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sabahattin Sül
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aylin Karalezli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Müjdat Karabulut.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the (place name of institution and/or national research committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Karabulut, M., Karabulut, S., Sül, S. et al. Optic nerve head microvascular changes after phacoemulsification surgery. Graefes Arch Clin Exp Ophthalmol 257, 2729–2733 (2019). https://doi.org/10.1007/s00417-019-04473-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-019-04473-1

Keywords

  • Optical coherence tomography angiography
  • Intraocular pressure phacoemulsification
  • Vessel density