Longitudinal Layer-Specific Revascularization Patterns Of Amniotic Membrane Transplantation Following Pterygium Surgery: An Octa Study
Published 2026 - 44th Congress of the ESCRS
Reference: PP23.01 | Type: Free paper | DOI: 10.82333/pb6w-bk42
Authors: Dr Amirhossein Hashemi 1 , Dr Seyedeh Zahra Seyedi 1 , Dr Ghazal Ghochani 1 , Dr Mahdi Soleimanzadeh 1 , Mohammadreza Nazari 1 , Dr Haniyeh Zeidabadinejad 1 , Dr Hamidreza ghanbari 1 , Ms Zahra Montazeriani 2 , Dr Mohamad Sanei 1 , Dr Ahmad Masoomi* 1
1Cornea and ocular surface,Farabi eye hospital,Tehran,Iran, Islamic Republic Of, 2Department of Medical Physics and Biomedical Engineering,Tehran university of medical sciences,Tehran,Iran, Islamic Republic Of
Purpose
To quantitatively evaluate the timeline and morphological patterns of amniotic membrane transplantation (AMT) revascularization using optical coherence tomography angiography (OCTA).
Setting
Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Methods
This prospective observational case series included 43 eyes undergoing primary pterygium excision with AMT. OCTA (AngioVue) was performed at 1, 4, and 12 weeks postoperatively. Images were segmented into superficial (0–200 µm) and deep (>200 µm) layers. Quantitative analysis of Vessel Density (VD), Vessel Length Density (VLD), and Vessel Diameter Index (VDI) was conducted using Adaptive Otsu binarization and skeletonization. Linear mixed models were used for longitudinal comparisons.
Results
Thirty-eight eyes completed the 12-week follow-up. Deep VD returned to baseline by Week 4 (0.365±0.140 vs 0.350±0.069 baseline, p>0.05) and remained stable at Week 12. Superficial recovery was incomplete; VD dropped significantly at Week 1 (0.230±0.071 vs 0.453±0.074 baseline, p<0.001) and remained below preoperative levels at Week 12 (0.321±0.061,p<0.05). VLD followed similar layer-specific trends, while VDI showed no significant changes (p=0.545), indicating stable vessel caliber. Qualitatively, fine anastomoses and segmental large-caliber vessels connected the graft to the episcleral bed by Week 4. However, persistent flow voids and irregular perfusion were still evident at Week 12.
Conclusions
AMT revascularization is a layer-specific process. Deep-layer integration through the episcleral bed occurs significantly faster than superficial conjunctival recovery. OCTA serves as a sensitive, non-invasive tool for monitoring subclinical graft integration and identifying persistent perfusion deficits that may impact long-term surgical success.