Early changes in retinal microcirculation after uncomplicated cataract surgery using an active-fluidics system.

PURPOSE To evaluate the early changes in retinal microcirculation after uncomplicated cataract surgery using an active-fluidics system. MATERIALS AND METHODS Patients underwent uncomplicated cataract surgery for both eyes were enrolled. The two eyes of the patients were randomly assigned to two groups, the active-fluidics group and the gravity-fluidics group. One eye using an active-fluidics system, and the other using a gravity-fluidics system. Optical coherence tomography angiography (OCTA) was performed at 1 day, 7 days, 30 days, and 90 days after surgery. RESULTS Fifty eyes (25 patients) were included in the final analysis. A significantly lower cumulative dissipated energy (CDE), estimated fluid usage (EFU), and total aspiration time (TAT) were observed in the active-fluidics group (all P<0.05). The superficial vessel density at parafoveal region increased at 7 days and 30 days after cataract surgery in the eyes of both the active-fluidics and gravity-fluidics groups, with the fluctuation in eyes of the gravity-fluidics group more significant. The vessel density of deep capillary plexus remained stable during the follow-up period. Significant changes of retinal thickness in macular region (fovea, parafovea) were observed in eyes of the gravity-fluidics group through the comparison of corresponding values at different time points (p = 0.008, 0.005). No significant change in retinal thickness was observed in eyes of the active-fluidics. CONCLUSIONS Retinal microcirculation and thickness were disturbed after cataract surgery using the gravity-fluidics infusion system. The active-fluidics system not only improved the surgical efficacy but also protected the retinal vasculature during cataract surgery. CLINICAL TRIALS REGISTRATION The study has been registered at www.clinicaltrials.gov with its clinical trial accession number of NCT0130500.