Investigation of conjunctival vasculature changes assessed by Anterior Segment Optical Coherence Tomography Angiography after photorefractive keratectomy: a pilot study.

PURPOSE: This prospective pilot study aimed to evaluate longitudinal changes in conjunctival microvascular morphology using Anterior Segment Optical Coherence Tomography Angiography (AS_OCTA) following photorefractive keratectomy (PRK) and to explore their relationships with visual outcomes and dry eye symptoms.

METHODS

In this prospective pilot study, fifteen patients undergoing PRK were assessed at baseline, 1 week, 1 month, and 3 months postoperatively. AS-OCTA was used to quantify superficial conjunctival vessel density (VD). Refractive and tomography values were evaluated concurrently. Exploratory correlations between vascular parameters, visual recovery, and tomography values were analyzed.

RESULTS

Visual acuity improved significantly after PRK, with mean UCVA advancing from 0.68 ± 0.08 preoperatively to 0.16 ± 0.08 at 1 month (p < 0.001), remaining stable through 3 months. Conjunctival vessel density (VD) decreased gradually from 0.38 ± 0.05 at baseline to 0.35 ± 0.05 at 3 months (p = 0.025). Exploratory correlation analyses within this pilot cohort showed a moderate positive correlation between 3-month VD and OSDI scores (r = 0.56, p = 0.03) and a moderate inverse correlation between 3-month VD and UCVA (r = -0.48, p = 0.07).

CONCLUSIONS

This pilot study demonstrates that PRK induces dynamic conjunctival microvascular changes, detectable by AS-OCTA. Our findings suggest that monitoring this microcirculation may provide insights into the postoperative healing process and potentially serve as a biomarker for recovery. The observed associations between vascularity, symptoms, and vision warrant further investigation in larger studies to confirm their clinical utility.