To assess changes in peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head parameters after cataract surgery by using spectral-domain optical coherence tomography (OCT).

Twenty-nine eyes of 26 patients, who underwent cataract surgery, were imaged with spectral-domain OCT before and after surgery to measure peripapillary RNFL thickness and optic nerve head parameters, signal strength (SS), quadrant, 12 clock-hour RNFL thickness, rim area, disc area, cup/disc area ratio, vertical cup/disc ratio, and cup volume.

The postoperative RNFL thickness and SS were higher than before surgery ( p < 0.05). Regarding optic nerve head parameters, rim area was 0.07 ± 0.10 mm² higher than before surgery and disc area, cup/disc area ratio, vertical cup/disc ratio, cup volume were 0.07 ± 0.15 mm², 0.04 ± 0.04, 0.03 ± 0.05, 0.04 ± 0.06 mm³, respectively, lower than before surgery ( p < 0.05).

Cataracts may decrease peripapillary RNFL thickness measurement and SS on OCT scans and change other optic nerve head parameters. Peripapillary RNFL thickness and optic nerve head parameter measurements should be interpreted with caution in eyes with significant cataracts.