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

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: IT<ITmean (34 eyes)]. 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: R 2 =0.372, P <0.001; 1-month postoperative: R 2 =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.