AS-OCTA evaluation of limbal vasculature changes after sclerocorneal and corneal cataract incisions

This prospective cohort study evaluated and compared changes in vascular density around sclerocorneal and corneal incisions for cataract surgery using anterior segment optical coherence tomography angiography (AS-OCTA). Twenty patients undergoing cataract surgery were divided into sclerocorneal and corneal (n = 10 each) incision groups. AS-OCTA imaging was performed preoperatively and at multiple intervals postoperatively. Vascular densities in the conjunctival and intrascleral layers were analyzed; postoperative changes were quantified using AS-OCTA. In the sclerocorneal incision group, the conjunctival vascular density was significantly reduced on days 1, 7, 21, and 90, while the intrascleral vascular density was significantly elevated on days 1, 3, 5, and 21. The corneal incision group showed an initial increase in conjunctival density on day 1, which rapidly returned to baseline. Intrascleral density increased on days 1 and 3 but returned to baseline thereafter. Significant between-group differences in intrascleral density were observed on days 3, 5, and 7. In the corneal incision group, a new intrascleral vessel network formed near the incision site between days 14 and 21 postoperatively, which gradually dissipated between days 28 and 90. AS-OCTA revealed that sclerocorneal incisions exhibited immediate and sustained vascular changes, whereas corneal incisions showed delayed, transient intrascleral vessel network formation.