Macular foveal retinal and choroidal thickness changes after phacoemulsification in high myopia cataract patients

This study investigates the association between macular foveal retinal and choroidal thicknesses (CTs) and postoperative visual outcomes in high myopia patients after phacoemulsification and IOL implantation. This retrospective study included 512 high myopia patients who underwent phacoemulsification from February 2022 to February 2024. Patients were categorized based on best-corrected visual acuity (BCVA) 3 months postoperatively: good vision group (BCVA ≥0.3, n = 247) and poor vision group (BCVA <0.3, n = 265). Macular foveal retinal thickness (RT) and CT were measured preoperatively, immediately postoperatively, and at 1 and 3 months postoperatively. Correlations between RT, CT, and BCVA, and their predictive value for BCVA were analyzed. At 3 months postoperatively, RT was significantly lower in the good vision group (250.13 ± 16.67 µm) than in the poor vision group (279.51 ± 12.69 µm) (P <.001). RT increased immediately after surgery and at 1-month postoperatively, but decreased by 3 months (P <.05). Similarly, at 3 months postoperatively, CT was significantly higher in the good vision group (249.36 ± 18.69 µm) than in the poor vision group (237.61 ± 19.38 µm) (P <.001), and CT also showed a gradual increase over time in both groups (P <.05). Preoperative RT was negatively correlated with BCVA (r = -0.721, P = .024), while CT was positively correlated with BCVA (R = 0.615, P = .031). Both RT and CT were significant predictors of BCVA (P <.05). Macular foveal retinal and CTs are key factors in visual recovery following cataract surgery in high myopia patients. Monitoring these metrics may aid in predicting visual outcomes and improving postoperative management.