Skip to main content

Advertisement

SpringerLink
Log in

Macular vascular density and visual function after phacoemulsification in cataract patients with non-pathological high myopia: a prospective observational cohort study

  • Cataract
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purposes

This study aimed to evaluate changes in macular vascular density and macular function in patients with high myopia cataract (HMC) after phacoemulsification surgery, using optical coherence tomography angiography (OCTA) and multifocal electroretinography (mfERG).

Methods

Patients with cataracts scheduled for phacoemulsification surgery were divided into a high myopia group (axial length > 26.5 mm) and a control group (22 mm < axial length ≤ 24.5 mm). OCTA examinations were performed before surgery and at 1 day, 1 week, 1 month, and 3–6 months post-surgery, while mfERG was conducted before surgery and at 3–6 months post-surgery.

Results

A total of 38 patients were included, of whom 20 were HMC patients and 18 were control patients. The macular vascular density significantly increased after phacoemulsification surgery in both groups, while foveal avascular zone area decreased significantly (HMC group: all p < 0.01; control group: all p < 0.05). Mean changes in macular vascular density were significantly greater in HMC patients than in the control group at 1 day after surgery (all p < 0.05). The amplitude density and latency of P1 wave in all macular rings (Ring1–5) did not differ significantly before or after surgery in either group (all p > 0.1).

Conclusion

Phacoemulsification may not affect HMC patients’ macular mfERG responses within 3–6 months post-surgery, but it may influence macular microcirculation. HMC patients should be closely monitored after surgery, as their retinal vascular density may fluctuate substantially in the early postoperative period.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data are available upon reasonable request.

References

  1. Morgan IG, French AN, Ashby RS et al (2018) The epidemics of myopia: aetiology and prevention. Prog Retin Eye Res 62:134–149. https://doi.org/10.1016/j.preteyeres.2017.09.004

    Article  PubMed  Google Scholar 

  2. Holden BA, Fricke TR, Wilson DA et al (2016) Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 123(5):1036–1042. https://doi.org/10.1016/j.ophtha.2016.01.006

    Article  PubMed  Google Scholar 

  3. Ikuno Y (2017) Overview of the Complications of High Myopia. Retina(Philadelphia, Pa.) 37(12):2347–2351. https://doi.org/10.1097/iae.0000000000001489

    Article  Google Scholar 

  4. Pan CW, Boey PY, Cheng CY et al (2013) Myopia, axial length, and age-related cataract: the Singapore Malay eye study. Invest Ophthalmol Vis Sci 54(7):4498–4502. https://doi.org/10.1167/iovs.13-12271

    Article  PubMed  Google Scholar 

  5. Kanthan GL, Mitchell P, Rochtchina E et al (2014) Myopia and the long-term incidence of cataract and cataract surgery: the Blue Mountains Eye Study. Clin Experiment Ophthalmol 42(4):347–353. https://doi.org/10.1111/ceo.12206

    Article  PubMed  Google Scholar 

  6. Qureshi MH, Steel DHW (2020) Retinal detachment following cataract phacoemulsification—a review of the literature. Eye (Lond) 34(4):616–631. https://doi.org/10.1038/s41433-019-0575-z

    Article  Google Scholar 

  7. Ng DS, Cheung CY, Luk FO et al (2016) Advances of optical coherence tomography in myopia and pathologic myopia. Eye (Lond) 30(7):901–916. https://doi.org/10.1038/eye.2016.47

    Article  CAS  Google Scholar 

  8. Cetinkaya S, Acir NO, Cetinkaya YF et al (2015) Phacoemulsificatıon in eyes wıth cataract and high myopia. Arq Bras Oftalmol 78(5):286–289. https://doi.org/10.5935/0004-2749.20150076

    Article  PubMed  Google Scholar 

  9. Tan Y, Liu L, Li J, et al (2021) Effect of cataract surgery on vision-related quality of life among cataract patients with high myopia: a prospective, case-control observational study. Eye (London, England). https://doi.org/10.1038/s41433-021-01697-6

  10. Chylack LT Jr, Wolfe JK, Singer DM et al (1993) The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol (Chicago, Ill.: 1960) 111(6):831–836. https://doi.org/10.1001/archopht.1993.01090060119035

    Article  Google Scholar 

  11. Hood DC, Bach M, Brigell M et al (2012) ISCEV standard for clinical multifocal electroretinography (mfERG) (2011 edition). Doc Ophthalmol 124(1):1–13. https://doi.org/10.1007/s10633-011-9296-8

    Article  PubMed  Google Scholar 

  12. Li M, Yang Y, Jiang H et al (2017) Retinal microvascular network and microcirculation assessments in high myopia. Am J Ophthalmol 174:56–67. https://doi.org/10.1016/j.ajo.2016.10.018

    Article  PubMed  Google Scholar 

  13. Leng Y, Tam EK, Falavarjani KG et al (2018) Effect of age and myopia on retinal microvasculature. Ophthalmic Surg Lasers Imaging Retina 49(12):925–931. https://doi.org/10.3928/23258160-20181203-03

    Article  PubMed  Google Scholar 

  14. Kader MA (2012) Electrophysiological study of myopia. Saudi J Ophthalmol 26(1):91–99. https://doi.org/10.1016/j.sjopt.2011.08.002

    Article  PubMed  Google Scholar 

  15. Ismael ZF, El-Shazly AAE, Farweez YA et al (2017) Relationship between functional and structural retinal changes in myopic eyes. Clin Exp Optom 100(6):695–703. https://doi.org/10.1111/cxo.12527

    Article  PubMed  Google Scholar 

  16. Hilton EJ, Hosking SL, Gherghel D et al (2005) Beneficial effects of small-incision cataract surgery in patients demonstrating reduced ocular blood flow characteristics. Eye (Lond) 19(6):670–675. https://doi.org/10.1038/sj.eye.6701620

    Article  CAS  Google Scholar 

  17. Ursell PG, Spalton DJ, Whitcup SM et al (1999) Cystoid macular edema after phacoemulsification: relationship to blood-aqueous barrier damage and visual acuity. J Cataract Refract Surg 25(11):1492–1497. https://doi.org/10.1016/s0886-3350(99)00196-0

    Article  CAS  PubMed  Google Scholar 

  18. Xu H, Chen M, Forrester JV et al (2011) Cataract surgery induces retinal pro-inflammatory gene expression and protein secretion. Invest Ophthalmol Vis Sci 52(1):249–255. https://doi.org/10.1167/iovs.10-6001

    Article  CAS  PubMed  Google Scholar 

  19. Bhagat K, Hingorani AD, Palacios M et al (1999) Cytokine-induced venodilatation in humans in vivo: eNOS masquerading as iNOS. Cardiovasc Res 41(3):754–764. https://doi.org/10.1016/s0008-6363(98)00249-1

    Article  CAS  PubMed  Google Scholar 

  20. Bamforth SD, Lightman SL, Greenwood J (1997) Interleukin-1 beta-induced disruption of the retinal vascular barrier of the central nervous system is mediated through leukocyte recruitment and histamine. Am J Pathol 150(1):329–340

    CAS  PubMed  PubMed Central  Google Scholar 

  21. De Maria M, Coassin M, Mastrofilippo V et al (2020) Persistence of inflammation after uncomplicated cataract surgery: a 6-month laser flare photometry analysis. Adv Ther 37(7):3223–3233. https://doi.org/10.1007/s12325-020-01383-1

    Article  CAS  PubMed  Google Scholar 

  22. Zhu X, Zhang K, He W et al (2016) Proinflammatory status in the aqueous humor of high myopic cataract eyes. Exp Eye Res 142:13–18. https://doi.org/10.1016/j.exer.2015.03.017

    Article  CAS  PubMed  Google Scholar 

  23. Zhao Y, Li X, Tao A et al (2009) Intraocular pressure and calculated diastolic ocular perfusion pressure during three simulated steps of phacoemulsification in vivo. Invest Ophthalmol Vis Sci 50(6):2927–2931. https://doi.org/10.1167/iovs.08-2996

    Article  PubMed  Google Scholar 

  24. Wong YL, Sabanayagam C, Wong CW et al (2020) Six-year changes in myopic macular degeneration in adults of the singapore epidemiology of eye diseases study. Invest Ophthalmol Vis Sci 61(4):14. https://doi.org/10.1167/iovs.61.4.14

    Article  PubMed  PubMed Central  Google Scholar 

  25. Wördehoff UV, Palmowski AM, Heinemann-Vernaleken B et al (2004) Influence of cataract on the multifocal ERG recording—a pre- and postoperative comparison. Doc Ophthalmol 108(1):67–75. https://doi.org/10.3892/etm.2020.9388

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors acknowledge all ophthalmic nurses and clinicians who provided us with convenience during the study.

Funding

This study was supported by The National Natural Science Foundation of China (81670869 to Wei Fan).

Author information

Authors and Affiliations

  1. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, China

    Yu Yang, Zhibing Zeng, Jiancheng Mu & Wei Fan

Authors
  1. Yu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zhibing Zeng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jiancheng Mu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wei Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Design and conduct of the study: YY, WF; Data collection, interpretation and analysis: YY, JM, BZ; Preparation of the manuscript: YY; Review of the manuscript: WF; Final approval of the manuscript: YY, WF, JM, BZ.

Corresponding author

Correspondence to Wei Fan.

Ethics declarations

Ethics approval and consent to participate

The study adhered to tenets of Declaration of Helsinki, and it was approved by the ethics review board of the West China Hospital of Sichuan University (ID: No 807, 2019). A written, informed consent was obtained from all the study participants.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note

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

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 33 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yang, Y., Zeng, Z., Mu, J. et al. Macular vascular density and visual function after phacoemulsification in cataract patients with non-pathological high myopia: a prospective observational cohort study. Graefes Arch Clin Exp Ophthalmol 260, 2597–2604 (2022). https://doi.org/10.1007/s00417-022-05606-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-022-05606-9

Keywords

Search

Navigation