Comparison of postoperative changes in radial peripapillary capillary density between femtosecond laser-assisted cataract surgery and conventional phacoemulsification surgery using optical coherence tomography angiography

Abstract

Purpose: To assess differences in post-surgical radial peripapillary capillary (RPC) density changes between femtosecond laser-assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) using optical coherence tomography angiography (OCTA).Methods: Fifty-two eyes of 52 patients were enrolled in this study. Depending on their preference, patients with age-related cataract underwent FLACS or CPS. Automated peripapillary maps and capillary density calculations were retrospectively evaluated using OCTA before surgery and on day 1 and months 1 and 3 postoperatively.Results: The whole-image and peripapillary RPC densities were lower at day 1 and months 1 and 3 postoperatively than before surgery in the FLACS group (all P < 0.05). However, there was no change in the whole-image and peripapillary RPC densities before and after surgery, across different time-points, in the CPS group (all P > 0.05). Moreover, comparison of data corresponding to each time-point between the FLACS and CPS groups showed no significant differences in any metrics prior to surgery (all P > 0.05). However, the whole-image and peripapillary RPC densities were significantly different at day 1 and month 1 after the surgery (all P < 0.05). At the 3-month follow-up, we did not observe significant differences (all P > 0.05). Conclusions: Postoperative whole-image and peripapillary RPC densities were lower in the FLACS group than in the CPS across time-points. While the short-term RPC density changes were resolved, to elucidate the long-term implications of FLACS, especially for eyes with glaucoma, diabetic retinopathy, etc., further investigations are required.