Purpose: To compare retinal vessel density, perfusion density, and foveal avascular zone using optical coherence tomography angiography (OCT-A) after uncomplicated cataract surgery in patients with and without diabetic retinopathy (DR). 

Setting: Single high volume ambulatory surgical centre.

Design: Prospective observational study.

Methods: IRB-approved study of patients undergoing phacoemulsification with intraocular lens implantation grouped into: control, diabetics with no DR and diabetics with any DR. Exclusion criteria were other ocular co-morbidities, poor signal strength on testing, or multifocal intraocular lens implantation. Optical coherence tomography (OCT) and OCT-A scans were obtained at baseline and postoperative week one, month one and month three. 

Results: 67 patients were included in the final analysis. 36 (53.7%) were in the control group, 22 (32.8%) were in the diabetic group, and 9 (13.4%) were in the DR group. There were no significant differences between the three groups at any time point for change in OCT or OCT-A parameters after surgery, from baseline. In the control and diabetic group, there were significant postoperative increases in vessel density and perfusion density, compared to baseline (P < 0.05). 

Conclusions: Vessel density and perfusion density significantly increase postoperatively in patients without diabetic retinopathy. There were no statistically significant differences in OCT-A parameters between the control, diabetic and DR groups following uncomplicated cataract surgery. Further studies are recommended to explore the significance of diabetes on OCT-A biomarkers in patients undergoing cataract surgery.

Optical coherence tomography angiography changes after uncomplicated cataract surgery in patients with and without diabetic retinopathy

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