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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.
Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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