Short-term postoperative changes in nucleus drop cases during phacoemulsification surgery: a comparative analysis of the choroidal vascular index following pars plana vitrectomy

Background

This study evaluated the clinical outcomes of cases of nucleus drop developing during phacoemulsification surgery. It particularly focused on analyzing the effects of pars plana vitrectomy (PPV) on postoperative visual and anatomical parameters, including choroidal thickness and the choroidal vascular index (CVI).

Methods

Patients who experienced nucleus drop during phacoemulsification and subsequently underwent PPV were reviewed retrospectively. Data for these cases were compared with a group of patients who underwent uncomplicated phacoemulsification and with a healthy control group. Key parameters assessed included surgical outcomes and changes in choroidal metrics, including quantitative assessments of choroidal thickness in various regions and the CVI, measured using enhanced depth imaging optical coherence tomography.

Results

Mean visual acuity in the PPV eyes was 0.44±0.11, significantly lower than the 0.71±0.13 in the phacoemulsification group and 0.80±0.08 in the controls (p < 0.001). Nasal choroidal thickness at 1000 µm was markedly lower in the PPV eyes (282.08±53.67 µm) compared with both the phacoemulsification (341.94±54.88 µm) and control (379.19±67.65 µm; p < 0.001) groups, with similar significant decreases being observed across other choroidal thickness parameters. However, no significant intergroup differences were observed in terms of CVI or stromal area/luminal area (LA/SA) ratio values (p > 0.05).

Conclusions

The study findings demonstrated that decreases observed in choroidal thickness, total choroidal area, luminal area, and stromal area measurements indicate that this procedure affects the anatomical structure. However, the similarities in CVI and LA/SA ratio values suggest that the relative balance within the microvascular structure is maintained.