Effect of infusion pressure during cataract surgery on ganglion cells measured using isolated-check visual evoked potential.

ABSTRACT

AIM: To detect the relationship between infusion pressure and postoperative ganglion cells function. METHODS: This prospective observational cohort study included sixty-one eyes that underwent uncomplicated cataract surgery. Patients were divided into two groups according to infusion time (IT) recorded using surgery equipment [Group A IT>ITmean (27 eyes); Group B ITeyes)]. Best-corrected visual acuity, isolated-check visual evoked potential (icVEP), microperimetry, and optical coherence tomography examinations were performed preoperatively and 1wk and 1mo postoperatively. The changes in test results were measured with independent-sample t-tests and paired t-tests. Correlation between IT and these changes were analyzed with Pearson's correlation analysis and Spearman correlation analysis.

RESULTS:

Neither group showed significant postoperative changes in macular ganglion cell-inner plexiform layer (mGC-IPL) thickness (1-week postoperative Group A P=0.185, Group B P=0.381; 1-month postoperative Group A P=0.775, Group B P=0.652). Postoperative mGC-IPL thickness of Group A was not significantly thicker than that of Group B at both post surgery time point (1-week postoperative P=0.913; 1-month postoperative P=0.954). In Group A, the mGC-IPL thickness change 1wk postoperatively was positively correlated with IT (R2=0.156, P=0.0198). A suspected progressive deficit in the magnocellular pathway was also found in Group A 1-month postoperatively [individual observed F (IOF)=0.63±0.70]. Significant increases were observed in postoperative retinal sensitivity measured by microperimetry (1-week postoperative Group A P=0.015, Group B P<0.001; 1-month postoperative Group A P=0.005, Group B P<0.001). In Group B, IT was negatively correlated with the increase in macular sensitivity (1-week postoperative R2=0.372, P<0.001; 1-month postoperative R2=0.209, P=0.007).

CONCLUSION:

Both mGC-IPL thickness and retinal sensitivity increased postoperatively. A suspected progressive deficit in the magnocellular pathway was found in the group with a long IT, which induced more prominent changes.