Do Changes in Cumulative Dissipated Energy cause Retinal Microcirculation Changes after Cataract Surgery?

Abstract

Background: There are obvious changes in retinal parameters after complicated phacoemulsification surgeries but there is a need to elucidate the relationship between surgical parameters and retinal outcomes after an uncomplicated cataract surgery also. Thus, we decided to study the impact of changes in cumulative dissipated energy (CDE) on retinal parameters after phacoemulsification.
Methods: Ninety subjects who underwent uncomplicated phacoemulsification for cataract were followed up as a cohort and assessed at baseline, 2 weeks, 6 weeks and 3 months. We divided CDE into two groups i.e. up to 15 and more than 15, and assessed the retinal parameter changes among these 2 groups. Central retinal thickness (CRT), central retinal thickness average (CRTA), vessel perfusion central (VPC), vessel perfusion full (VPF), central retinal volume (CRV), vessel density central (VDC) and vessel density full (VDF) were the retinal parameters taken using OCT angiography (OCTA). Functional outcome in the form of best corrected visual acuity (BCVA) log MAR was also assessed at all visits.
Results: There was a significant difference between the CDE among the 2 groups, i.e. 9.89 vs 20.78 (p<0.001) but despite this the only retinal parameter which showed a significant difference among the 2 study groups was the vascular density full (VDF). The difference in VDF was maintained at all three follow-up assessments i.e. 2 weeks (p=0.026), 6 weeks (p=0.022) and 3 months (p=0.017).
Conclusions: In our study, both high-CDE and low-CDE groups did not have a significant impact on retinal microcirculation, except with vessel density full (VDF). There was no deterioration in BCVA at any visit in either group. A long-term follow-up study is needed to study the persistence of these changes and the development of pseudophakic cystoid edema (PCME) in these subjects.