Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review

Introduction: Age-related cataracts are the leading cause of blindness worldwide, and phacoemulsification is the standard surgical treatment. Optical coherence tomography angiography (OCTA) enables non-invasive assessment of these microvascular changes. However, findings from individual studies rema...

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Autores: García Oliver, Raquel, Sánchez González, María del Carmen, Caro Magdaleno, Manuel
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:dnet:idus________::579d435dd29b5b120b7d6edf2f67cba6
Acceso en línea:https://hdl.handle.net/11441/184836
https://doi.org/10.1007/s40123-025-01306-9
Access Level:acceso abierto
Palabra clave:Foveal avascular zone
Optical coherence tomography angiography
Perfusion density
Phacoemulsification
Vascular density
Vessel density
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spelling Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic ReviewGarcía Oliver, RaquelSánchez González, María del CarmenCaro Magdaleno, ManuelFoveal avascular zoneOptical coherence tomography angiographyPerfusion densityPhacoemulsificationVascular densityVessel densityIntroduction: Age-related cataracts are the leading cause of blindness worldwide, and phacoemulsification is the standard surgical treatment. Optical coherence tomography angiography (OCTA) enables non-invasive assessment of these microvascular changes. However, findings from individual studies remain inconsistent. This systematic review aimed to determine potential vascular changes in the macula and optic nerve using OCTA following phacoemulsification. Methods: This review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three different databases—Scopus, PubMed and Web of Science—were searched for relevant studies published from 2015 to June 2025. Study quality was assessed using the Study Quality Assessment Tools developed by the National Heart, Lung, and Blood Institute (NHLBI). Among the identified studies, 21 were included in the review. All included studies assessed the changes in the retinal vascular network following phacoemulsification. Results: The quality of most of the studies was moderate to high. Most studies reported an increase in vascular density in various vascular plexuses, though these changes varied by retinal region, vascular plexus, and follow-up duration. A reduction in the foveal avascular zone (FAZ) was also observed. These changes may be attributed to post-operative inflammation, decreased intraocular pressure (IOP) and increased retinal metabolism. Conclusions: The results from this systematic review reveal that most included studies reported an increase in vascular density in various plexuses. These changes varied depending on retinal region, specific plexus, and followup duration. Additionally, a reduction in the FAZ was commonly observed. Patient-specific factors, such as diabetes and myopia, were associated with variability in vascular response.Springer NatureFísica de la Materia CondensadaCirugíaInstituto de Salud Carlos III2026info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttps://hdl.handle.net/11441/184836https://doi.org/10.1007/s40123-025-01306-9reponame:idUS. Depósito de Investigación de la Universidad de Sevillainstname:Universidad de Sevilla (US)InglésOphthalmology and Therapy, 15 (2), 641-675. RD 24/0007/0035https://link.springer.com/article/10.1007/s40123-025-01306-9info:eu-repo/semantics/openAccessoai:dnet:idus________::579d435dd29b5b120b7d6edf2f67cba62026-06-17T12:51:07Z
dc.title.none.fl_str_mv Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
title Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
spellingShingle Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
García Oliver, Raquel
Foveal avascular zone
Optical coherence tomography angiography
Perfusion density
Phacoemulsification
Vascular density
Vessel density
title_short Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
title_full Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
title_fullStr Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
title_full_unstemmed Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
title_sort Post-phacoemulsification Vascular Changes in the Macula and Optic Nerve Using Optical Coherence Tomography Angiography: A Systematic Review
dc.creator.none.fl_str_mv García Oliver, Raquel
Sánchez González, María del Carmen
Caro Magdaleno, Manuel
author García Oliver, Raquel
author_facet García Oliver, Raquel
Sánchez González, María del Carmen
Caro Magdaleno, Manuel
author_role author
author2 Sánchez González, María del Carmen
Caro Magdaleno, Manuel
author2_role author
author
dc.contributor.none.fl_str_mv Física de la Materia Condensada
Cirugía
Instituto de Salud Carlos III
dc.subject.none.fl_str_mv Foveal avascular zone
Optical coherence tomography angiography
Perfusion density
Phacoemulsification
Vascular density
Vessel density
topic Foveal avascular zone
Optical coherence tomography angiography
Perfusion density
Phacoemulsification
Vascular density
Vessel density
description Introduction: Age-related cataracts are the leading cause of blindness worldwide, and phacoemulsification is the standard surgical treatment. Optical coherence tomography angiography (OCTA) enables non-invasive assessment of these microvascular changes. However, findings from individual studies remain inconsistent. This systematic review aimed to determine potential vascular changes in the macula and optic nerve using OCTA following phacoemulsification. Methods: This review was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three different databases—Scopus, PubMed and Web of Science—were searched for relevant studies published from 2015 to June 2025. Study quality was assessed using the Study Quality Assessment Tools developed by the National Heart, Lung, and Blood Institute (NHLBI). Among the identified studies, 21 were included in the review. All included studies assessed the changes in the retinal vascular network following phacoemulsification. Results: The quality of most of the studies was moderate to high. Most studies reported an increase in vascular density in various vascular plexuses, though these changes varied by retinal region, vascular plexus, and follow-up duration. A reduction in the foveal avascular zone (FAZ) was also observed. These changes may be attributed to post-operative inflammation, decreased intraocular pressure (IOP) and increased retinal metabolism. Conclusions: The results from this systematic review reveal that most included studies reported an increase in vascular density in various plexuses. These changes varied depending on retinal region, specific plexus, and followup duration. Additionally, a reduction in the FAZ was commonly observed. Patient-specific factors, such as diabetes and myopia, were associated with variability in vascular response.
publishDate 2026
dc.date.none.fl_str_mv 2026
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/11441/184836
https://doi.org/10.1007/s40123-025-01306-9
url https://hdl.handle.net/11441/184836
https://doi.org/10.1007/s40123-025-01306-9
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Ophthalmology and Therapy, 15 (2), 641-675.
RD 24/0007/0035
https://link.springer.com/article/10.1007/s40123-025-01306-9
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:idUS. Depósito de Investigación de la Universidad de Sevilla
instname:Universidad de Sevilla (US)
instname_str Universidad de Sevilla (US)
reponame_str idUS. Depósito de Investigación de la Universidad de Sevilla
collection idUS. Depósito de Investigación de la Universidad de Sevilla
repository.name.fl_str_mv
repository.mail.fl_str_mv
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