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Objective: To assess changes in choroidal thickness and choroidal volume following uncomplicated cataract surgery using enhanced depth imaging optical coherence tomography (EDI-OCT) over a three-month follow-up period.

Methods: In this retrospective analysis, data originally collected in a previously conducted prospective study at the Department of Ophthalmology, Medical University of Graz, Austria, were re-evaluated. In the initial study, retinal layer thicknesses were measured using spectral-domain optical coherence tomography (SD-OCT) preoperatively and at 1 day, 1 month, and 3 months after surgery. For the present analysis, the automated retinal segmentation was manually adjusted to the level of the choroid and evaluated using EDI-OCT. Choroidal thickness was assessed in the central subfield (1 mm) and in the superior, inferior, temporal, and nasal sectors of the inner ring (3 mm). In addition, choroidal volume was calculated for the inner and outer rings (3 mm and 6 mm) of the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Forty-one patients who underwent uncomplicated cataract surgery between February 2016 and October 2017 were included. Patients with pre-existing ocular or systemic disease, intraoperative complications, or inadequate image quality were excluded.

Results: A total of 42 eyes from 41 patients (mean age 70.2 ± 8.7 years; 51.2% male) were included in the analysis. A significant increase in both choroidal thickness and choroidal volume was observed in nearly all ETDRS sectors, reaching a maximum one month postoperatively (p ≤ 0.05). This was followed by a decline by the third postoperative month, although values remained above baseline. Five eyes (11.9%) developed cystoid macular edema. The overall postoperative pattern of structural changes was similar in patients with and without cystoid macular edema.

Conclusion: The findings indicate significant postoperative alterations in choroidal thickness and volume after uncomplicated cataract surgery. Potential mechanisms include acute inflammatory responses, hemodynamic adaptations to postoperative fluctuations in intraocular pressure, and metabolic changes associated with improved optical transmission.