AIM:To provide a clinical reference for the design of personalized surgical parameters for cataract, swept source optic coherence tomography angiography(SS-OCTA)was applied to comparatively study the blood flow of the macular area before operation in patients with different intraocular pressure during cataract surgery.

METHODS: Prospective randomized controlled study. A total of 61 patients(77 eyes)who underwent cataract surgery in Sichuan Provincial People's Hospital from January to April 2021 were collected and divided into group A(37 eyes)and group B(40 eyes)for the study using a random number table. Group A and group B received the height of 75 and 90cm perfusion bottles with intraoperative,corresponding to 55.5 and 66.6mmHg intraoperative mean intraocular pressure,respectively. All patients were examined with SS-OCTA in macula area before and 1,7 and 30d after surgery, except routine ophthalmologic examination, the macular retinal thickness, the perfusion area and vessel density of the radial perioptic capillary plexus(RPCP)layer, superficial vascular plexus(SVP)layer, intermediate vascular plexus(IVP)layer and deep vascular plexus(DVP)layer were observed.

RESULTS: There were no significant differences in the best corrected visual acuity(BCVA), intraocular pressure, foveal avascular zone(FAZ), macular retinal thickness, perfusion area and vascular density between the two groups at each time point before and after surgery(all P>0.05),but there were differences in time(all P<0.05). In both groups, BCVA improved significantly from preoperative values at all time points after surgery, intraocular pressure and FAZ decreased compared with preoperative values(all P<0.05), and macular retinal thickness, perfusion area in all layers, and blood flow density were increased compared with preoperative values.

CONCLUSION:The macular retinal thickness, blood flow density and perfusion area of all layers increased,and the FAZ area decreased after cataract surgery, which may help to promote the recovery of visual acuity after surgery. At different intraocular pressures of 55.5 and 66.6mmHg intraoperatively, there was no significant difference in the patients'postoperative fundus blood flow changes, therefore, intraocular pressure can be flexibly selected during the operation to provide patients with personalized surgical design.