Effect of cataract surgery on macular and peripapillary optical coherence tomography values.

PURPOSE: To evaluate the effects of cataract surgery on peripapillary retinal nerve fiber layer (pp-RNFL) and macular thickness measurements, obtained by optical coherence tomography (OCT).

METHODS

In this prospective before-after study, both pp- and macular scans were obtained within two days before and then two weeks after surgery. Cataract density was graded using the Lens Opacities Classification System (LOCS) III. Pre- and postoperative quality scores and thicknesses were compared.

RESULTS

In 100 studied eyes of 100 patients, quality scores and thickness values increased postoperatively. (all P < 0.001). The greatest change was observed at the nasal superior sector of pp-OCT (5.28 ± 11.11µm) and the temporal quadrant of 3-mm-diameter circle (7.40 ± 9.13 µm) of macular scans. Changes in the quality score were significantly correlated with changes in global, nasal, and temporal-inferior pp-RNFL thicknesses and none of macular sectors. The greatest changes in pp-RNFL and macular thicknesses were observed with posterior subcapsular and the least with cortical cataracts. In 14 eyes, the increase in pp-RNFL thickness measurements resulted in a change in color display of pie charts. In this subset of patients, significant positive correlation was observed between global thickness change and quality change. (r = 0.217, P = 0.033).

CONCLUSION

Cataract surgery significantly improves the quality score and thickness values of both pp- and macular OCT. Correcting OCT-derived pp-RNFL thicknesses in eyes with significant cataracts is needed to prevent misdiagnosis of glaucoma.