Anterior segment optical coherence tomography angiography assessment of limbal vasculature changes after sclerocorneal vs. corneal cataract incisions

This prospective cohort study aimed to compare changes in vascular density around sclerocorneal and corneal incisions after cataract surgery using anterior segment optical coherence tomography angiography (AS-OCTA). To this end, 20 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, and 21, while intrascleral vascular density significantly increased 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 was 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 reveals that sclerocorneal incisions exhibit immediate and sustained vascular changes, whereas corneal incisions show delayed, transient intrascleral vessel network formation.