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Subject Area

Internal Medicine

Article Type

Original Study

Abstract

Objective The objectives of the study were assessment of the effect of phacoemulsification on the retinal nerve fiber layer (RNFL) and macular thickness compared with preoperative thickness, and assessment of the correlation between phaco time and the macular thickness changes after surgery. Backgrounds Phacoemulsification is the most common technique used for cataract surgery. Ultrasonic energy and fluidics produce inflammatory reactions that lead to cystoid macular edema. Patients and methods The present study included 50 eyes of 50 patients who underwent phacoemulsification. RNFL thickness and macular thickness were measured 1 day before phacoemulsification and 1 week and 1 month after the operation using the spectral domain optical coherence tomography at the ophthalmology clinic at the Menoufia University Hospital, and the phaco time was estimated during the operation. Results The average retinal nerve fiber thickness was 96.52 ± 12.00, 101.28 ± 11.87, and 111.96 ± 11.43 μm, 1 day before cataract surgery, after first week of surgery, and after 1 month, respectively. We found that the central retinal nerve fiber thickness measurements after 1 week and 1 month of the operation were significantly higher than those measured preoperatively (P < 0.001). The average central macular thickness was 230.58 ± 25.46, 259.22 ± 25.44, and 271.12 ± 24.61 μm 1 day before phacoemulsion, after 1 week of surgery, and 1 month later, respectively. We found a statistically significant increase in the central macular thickness in the first week and the first month after surgery than before the procedure (P < 0.001). This increase in macular thickness was significant in all nine areas of macula (P < 0.001). The increase of macular thickness is positively correlated with the phaco time after first week (P < 0.001) and first month of phacoemulsification (P = 0.001). Conclusion Phacoemulsification leads to a significant increase in the central retinal nerve fiber thickness and in nine macular area thicknesses after 1 week and 1 month of phacoemulsification than before the procedure. These results support the concept that ultrasonification in phacoemulsification leads to an inflammatory reaction causing macular edema, and the removal of opacified media improves the transmittance and reflectivity of the RNFL boundary, so the RNFL thickness increases after phacoemulsification.

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