OCT-BASED ANALYSIS OF MACULAR THICKNESS CHANGES AFTER UNCOMPLICATED PHACOEMULSIFICATION IN A TERTIARY CARE HOSPITAL

Abstract

Background: Phacoemulsification is the standard technique for cataract surgery, offering rapid postoperative visual recovery. However, subtle macular changes, such as postoperative macular edema, can occur and may influence visual outcomes. Optical coherence tomography (OCT) allows precise assessment of retinal structural changes following surgery. Objective: To assess changes in central macular thickness (CMT) using OCT following uncomplicated phacoemulsification and correlate these changes with postoperative visual outcomes. Study Design: Prospective observational study. Setting: Department of Ophthalmology at Hayatabad Medical Complex, Peshawar, Pakistan. Duration of Study: 02-January-2025—02-August-2025. Methods: Sixty-one patients undergoing uncomplicated phacoemulsification were enrolled. Preoperative baseline CMT measurements were obtained using spectral-domain OCT. Postoperative follow-up included CMT and best-corrected visual acuity (BCVA) assessment at 1, 4, and 8 weeks. The association between CMT and BCVA at 8 weeks was analyzed. Statistical significance was set at p ≤ 0.05. Results: The mean age of participants was 59.70 ± 11.78 years, with 57.4% males. The mean preoperative CMT was 190.91 ± 6.32 µm, which increased significantly to 210.81 ± 6.06 µm at 1 week (p = 0.0001), peaked at 225.65 ± 1.06 µm at 4 weeks (p = 0.0001), and reduced to 213.86 ± 3.83 µm by week 8 (p = 0.0001). BCVA at 8 weeks demonstrated excellent improvement (0.04 ± 0.03 logMAR). No significant correlation was found between final CMT and BCVA (r = –0.06, p = 0.61). Conclusion: Uncomplicated phacoemulsification results in a transient increase in macular thickness, peaking approximately 1 month after surgery and resolving. Despite structural changes, visual acuity outcomes remain excellent, and CMT alterations do not correlate with postoperative vision.