The effect of phacoemulsification performed with vitrectomy on choroidal vascularity index in eyes with vitreomacular diseases

Abstract

This study evaluated the effects of cataract surgery combined with pars plana vitrectomy (ppV) on choroidal vascularity index (CVI) in eyes with epiretinal membrane (ERM) and full thickness macular hole (FTMH). Medical records of 132 eyes with ERM or FTMH were retrospectively reviewed and classified into a ppV group and a ppV combined with cataract surgery group (phaco + ppV group). The CVI were measured at baseline, 1, 3 and 6 months after the surgery, using the selected swept-source (SS) optical coherence tomography (OCT) scan passing through the central fovea, which was then segmented into luminal and stromal area by image binarization. The mean CVI of phaco + ppV group were 61.25 ± 1.97%, 61.66 ± 1.81%, and 62.30 ± 1.92% at baseline, 1 and 3 months, respectively (p < 0.001). The mean CVI of ppV group were 62.69 ± 1.92%, 62.03 ± 1.51%, and 61.45 ± 1.71% at baseline, 1 and 3 months, respectively (p < 0.001). The final CVI were measured at 6 months and compared with the baseline CVI. The mean CVI of phaco + ppV group were 61.21 ± 1.99% at baseline and 60.68 ± 2.02% at 6 months (p < 0.001). The mean CVI of ppV group were 62.93 ± 1.70% at baseline and 61.77 ± 1.74% at 6 months (p < 0.001). Vitrectomy significantly decreases CVI in vitreomacular diseases possibly due to the removal of vitreomacular traction or postoperative oxygenation change in the eye. On the contrary, combined surgery of vitrectomy and cataract surgery significantly increases CVI in the early stage of postoperative period, which suggests choroidal vascular dilatation or congestion due to postoperative inflammation. Although the CVI were measured lower than the baseline in the end, more thorough inflammation control may be essential after combined surgery.

Choroidal structural changes following vitrectomy performed with phacoemulsification in unilateral idiopathic epiretinal membrane

“…In addition, the reduced IOP is likely to cause increased CT in the early period following phacoemulsification performed with or without vitrectomy due to increased ocular perfusion pressure [ 21 , 22 ]. The present study demonstrated that the CT/CVI increased in the early postoperative period, which is similar to that reported in ERM and MH patients undergoing vitrectomy [ 21 , 23 ]. Therefore, the upregulation of proinflammatory cytokines and the decreased IOP after surgery might cause an increased CVI/CT after combined vitrectomy.…”

Postoperative choroidal vascularity index after the management of macula-off rhegmatogenous retinal detachment

“…The CVI has proven to be informative in revealing the status of the choroidal vasculature in a variety of disease and treatment conditions [ 16 – 21 ]. The main objectives of this study were as follows: (1) to compare CVI in eyes with surgically resolved macula-off RRD treated with either primary vitrectomy alone or SB combined with vitrectomy; (2) to contribute to the analysis of submacular CVI as a marker; and (3) to create a multivariate linear model to identify potential correlations among final BCVA, age, CVI, the number of weeks with a detached macula, and the follow-up time after surgery.…”

Short-term postoperative changes in the choroidal vascularity index in patients with a unilateral epiretinal membrane

“…Rizzo et al found that the CVI of eyes with ERM decreased at 1 and 3 months after vitrectomy [ 26 ]. Chun et al reported a long-term decrease in CVI in the PPV-alone group and a short-term increase in the PPV combined with cataract surgery group [ 27 ]. However, these studies analyzed CVI changes over a longer postoperative period.…”