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Purpose <p>To compare, using optical coherence tomography angiography (OCTA), the earliest changes and damages to macular and optic disc microcirculation after active-fluidics system (AFS) and gravity-fluidics system (GFS) procedures in uncomplicated cataract surgery.</p> Methods <p>We included 42 eyes affected by uncomplicated cataracts and divided them into two groups: 21 eyes were randomly assigned to an AFS group and 21 eyes were randomly assigned to a GFS group. Expert examiners performed OCTA 30 ± 10&#xa0;min before surgery (T0), 30 ± 8&#xa0;min after surgery (T1), 24 ± 2&#xa0;h after surgery (T2) and 7 days after surgery (T3).</p> Results <p>No significant differences at T1 were detected between the groups. At T2, eyes in the GFS group exhibited a whole macula deep capillary plexus vessel density of 37.9 ± 5.8%, which was significantly lower than that of the eyes in the AFS group (42.2 ± 5.7%; <i>p</i> = 0.048). At T3, eyes in the GFS group exhibited a significantly higher retinal nerve fibre layer thickness in the nasal (<i>p</i> = 0.020) and inferior (<i>p</i> = 0.045) quadrant, and a significantly lower peripapillary vessel density in the inferior quadrant of the papilla (<i>p</i> = 0.036) compared with eyes in the AFS group.</p> Conclusion <p>The AFS procedure appears to protect macular and optic disc microcirculation during phacoemulsification, and it may represent a more prudent approach, particularly in cases that require specific care to preserve residual peripapillary and macular vasculature (e.g., diabetic or glaucomatous eyes).</p>

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Active-fluidics versus gravity-fluidics in uncomplicated cataract surgery: using optical coherence tomography angiography to estimate early changes in macular and optic disc microcirculation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月5日

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  • Alessandra Scampoli,
  • Emanuele Crincoli,
  • Lorenzo Governatori,
  • Carlo Monaco,
  • Cosma Danilo Mancini,
  • Federico Giannuzzi,
  • Matteo Mario Carlà,
  • Giulia Grieco,
  • Stanislao Rizzo,
  • Tomaso Caporossi

摘要

Purpose

To compare, using optical coherence tomography angiography (OCTA), the earliest changes and damages to macular and optic disc microcirculation after active-fluidics system (AFS) and gravity-fluidics system (GFS) procedures in uncomplicated cataract surgery.

Methods

We included 42 eyes affected by uncomplicated cataracts and divided them into two groups: 21 eyes were randomly assigned to an AFS group and 21 eyes were randomly assigned to a GFS group. Expert examiners performed OCTA 30 ± 10 min before surgery (T0), 30 ± 8 min after surgery (T1), 24 ± 2 h after surgery (T2) and 7 days after surgery (T3).

Results

No significant differences at T1 were detected between the groups. At T2, eyes in the GFS group exhibited a whole macula deep capillary plexus vessel density of 37.9 ± 5.8%, which was significantly lower than that of the eyes in the AFS group (42.2 ± 5.7%; p = 0.048). At T3, eyes in the GFS group exhibited a significantly higher retinal nerve fibre layer thickness in the nasal (p = 0.020) and inferior (p = 0.045) quadrant, and a significantly lower peripapillary vessel density in the inferior quadrant of the papilla (p = 0.036) compared with eyes in the AFS group.

Conclusion

The AFS procedure appears to protect macular and optic disc microcirculation during phacoemulsification, and it may represent a more prudent approach, particularly in cases that require specific care to preserve residual peripapillary and macular vasculature (e.g., diabetic or glaucomatous eyes).