Purpose: To study the changes in vascular density around incisional wound after cataract surgery using anterior segment optical coherence tomography angiography (AS-OCTA).
Subjects and methods: Among patients who underwent cataract surgery through a single corneoscleral incision approach, 10 eyes of 10 patients (mean age, 72.8±6.8 years) who underwent AS-OCTA (PLEX Elite 9000, Carl Zeiss Meditec) after the surgery were included in the study. OCTA programs (6×6 mm and 3×3 mm) were used to capture the images of the area around the incisional wound on the upper conjunctiva on the day before surgery and on days 1,3, 5,7, 14,21 after surgery as well as 1 and 3 months after surgery. The images were categorized into three groups: whole eye, superficial layer (0-200 μm from the conjunctival surface, indicating the region from the conjunctiva to the shallow layer of the sclera), and deep layer (200-1000 μm from the conjunctival surface, indicating the sclera). The vascular density was evaluated in each group using ImageJ (National Institute of Health).
Results: Using the 6×6 mm program, a significant increase in vascular density was observed on days 1,3, 5,7, 14, and 21 compared with day 0 (p<0.01), and the rate of the increase was approximately 45% on day 3 after surgery in the whole eye. No significant changes in vascular density were observed in the superficial layer on any measurement day. Further, a significant increase in vascular density was observed in the deep layer on days 1,3, and 5 compared with day 0 (p<0.01), and the rate of the increase was approximately 90% on day 3 after surgery. Imaging revealed a cross-linking of limbal vessels in the wound on day 14 after surgery, suggesting that the regeneration or recanalization of corneal limbal vascular hoof reticulation began on day 5 after surgery.
Conclusions: AS-OCTA allowed us to observe changes in vascular density and vascular motion around the incisional wound before and after cataract surgery over time and in a stratified manner. The study revealed that the process of vascular remodeling around the wound after cataract surgery followed a stratified and different course. AS-OCTA could evaluate the vascular motion and vascular density around the incisional wound after cataract surgery.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 1046-1056,2022.