Ophthalmology in China ›› 2026, Vol. 35 ›› Issue (5): 386-392.doi: 10.13281/j.cnki.issn.1004-4469.2026.05.007

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Impact of posterior continuous curvilinear capsulorhexis on macular choroidal capillary vessel density and central macular thickness after cataract surgery

Zhai Xinran1, 2, Li Jiayu1, 2, Ma Gaoyang1, Qin Na1, 2, Cao He2, 3, Ma Shuqi1, 2, Liu Yandong2, Yang Hongyu2, Zhang Yinbo2, Li Ruifang2, Shan Li2, Liang Su2, Zhang Yue2   

  1. 1 Hebei Eye Hospital, Provincial Key Laboratory of Ophthalmology, Hebei Provincial Clinical Research Center for Eye Diseases, Xingtai Hebei 054001, China; 2 Department of Ophthalmology Teaching and Researching, Hebei Medical University, Shijiazhuang 050017, China; 3 Department of Ophthalmology, School of Clinical Medicine, North China University of Science and Technology, Tangshan Hebei 063210, China
  • Received:2026-01-26 Online:2026-09-25 Published:2026-09-18
  • Contact: Zhang Yue, Email: zhangyueyk@163.com
  • Supported by:
    Key R&D Plan Self Funded Project of Xingtai City (2023ZC175); Central Guiding Local Science and Technology Development Fund Project (Basic Research Project) (264Z7766G)

Abstract:  Objective To investigate the effect of primary posterior continuous curvilinear capsulorhexis (PCCC) combined with phacoemulsification on postoperative choriocapillaris flow density (CFD) and central macular thickness (CMT) in the macular region. Design Prospective comparative case series. Participants A total of 100 patients (100 eyes) with age-related cataract who underwent phacoemulsification surgery. Methods Based on the intraoperative status of the posterior capsule during phacoemulsification, patients in whom polishing failed to remove posterior capsule opacification were assigned to the PCCC group (50 eyes), while those with removable posterior capsule opacification or without opacification were assigned to the control group (50 eyes). All patients underwent optical coherence tomography angiography (OCTA) examination preoperatively and on 1 day, 1 week, 1 month, and 3 months postoperatively. Main Outcome Measures Macular CFD and CMT. Results The CFD in the PCCC group was significantly lower than that in the control group at both 1 month and 3 months postoperatively (1 month: 59.18%±3.00% vs. 61.28%±2.86%, P<0.001; 3 months: 60.24%±3.29% vs. 62.98%±2.63%, P<0.001), and the CMT at 1 month postoperatively was significantly higher in the PCCC group than in the control group (267.58±15.66 μm vs. 255.80±15.90 μm, P<0.001). Correlation analysis revealed a significant negative correlation between CFD and CMT at 1 month postoperatively in the PCCC group (r=-0.319, P=0.024). Multiple linear regression analysis showed that the application of PCCC was an independent influencing factor for the change in postoperative CMT (β=-8.071, P=0.006). No clinically significant macular edema occurred in either group. Conclusion PCCC in patients with age-related cataract may lead to a slight decrease in macular CFD and a mild increase in CMT during the early postoperative period. However, these transient anatomical changes are primarily subclinical in nature. PCCC surgery demonstrates favorable short-term safety in patients with age-related cataract.

Key words: Primary posterior continuous curvilinear capsulorhexis, Optical coherence tomography angiography, Choriocapillaris flow density, Central macular thickness