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Purpose: To compare data on anatomical and biometric parameters, and their combination, obtained by using ultrasound biomicroscopy (UBM) and A-scan in eyes with phacomorphic glaucoma (PG) and eyes with mature cataract and to determine differences that may predispose to development of PG., Methods: Eighty patients (80 eyes) were enrolled in this cross-sectional study. Anterior chamber parameters, namely anterior chamber depth (ACD), angle-opening distance (AOD), iris-lens contact distance (ILCD), and trabecular-ciliary process distance (TCPD), among other parameters, were assessed by UBM (35 MHz), while axial length (AL) and lenticular thickness (LT) were determined by A-scan biometry. Absolute lenticular position (ALP) and relative lenticular position (RLP) were also compared., Results: The mean AL of eyes with PG was less (P = 0.64) than the mean AL of eyes with mature cataract. The mean ILCD value in eyes with PG (1.30 ± 0.78 mm) was significantly higher (P = 0.0015) than that in eyes with mature cataract (0.86 ± 0.32 mm). The mean AOD value in eyes with PG (0.15 ± 0.10 mm) was significantly lower (P < 0.0001) than that in eyes with mature cataract (0.23 ± 0.06 mm); similarly, the mean RLP value in eyes with PG (0.20 ± 0.02) was significantly lower (P < 0.0001) than that in eyes with mature cataract (0.17 ± 0.02). TCPD showed negative correlation with LT r = -0.514; P = 0.017, r 2  = 0.264, in eyes with phacomorphic glaucoma and mature cataracts showed significant negative correlation of ILCD with AL (r = -0.575; P = 0.025, r 2  = 0.330)., Conclusion: The results of UBM examination suggest that there are multiple mechanisms underlying the pathophysiology of PG, namely crowding of the anterior segment, increased iris-lens contact distance, and a more pronounced anterior shift of the lens. Simultaneous evaluation of anatomic and biometric parameters can improve diagnostic accuracy in predicting cases at risk for PG.

Background: In microspherophakia, abnormal laxity of the lenticular zonules leads to development of a spherical lens and possible subluxation. We evaluated long-term results of lens removal with scleral-fixated intraocular lens (SFIOL) implantation in microspherophakia., Materials and Methods: Case series. SF IOLs were implanted in four consecutive patients with bilateral microspherophakia (eight eyes [three with pupillary block and secondary glaucoma who underwent immediate surgery and five with only subluxation who underwent elective surgery]). Post-operative best-corrected visual acuity (BCVA), intraocular pressure (IOP) and lens position were evaluated periodically from day 1 to 18 months., Results: All patients were females (mean age 28 ± 7.03 years). In group 1 eyes (three eyes that presented with pupillary block), the mean BCVA improved from 0.008 decimals (preoperative) to 0.50 decimals (final post-operative visit); in group 2 eyes (the other five eyes), the mean BCVA improved from 0.12 ± 0.21 decimals to 0.73 ± 0.14 decimals. The preoperative mean IOP (54.53 ± 7.33 mmHg) in group 1 eyes was significantly (P = 0.03) higher than that (16 ± 4.30 mm Hg) in group 2 eyes. At final post-operative visit, the mean IOP (11.67 ± 2.88 mmHg) in group 1 eyes was not significantly different from that in group 2 eyes (13.0 ± 3.08 mmHg). All SFIOLs were well- centred at the final visit. None of the patients encountered any peroperative or postoperative complications., Conclusions: SFIOLs may be an option for surgical management of microspherophakia.

Background: To correlate the findings of optical coherence tomography (OCT) evaluation of retinal nerve fiber layer (RNFL) thickness with visual field changes in glaucomatous, ocular hypertensive and normal eyes., Materials and Methods: Thirty consecutive normal, 30 consecutive ocular hypertensive and 30 consecutive glaucomatous eyes underwent a complete ophthalmic examination, including applanation tonometry, disc evaluation, (30-2) Humphrey field analyzer white on white (W/W) perimetry and short- wavelength automated perimetry. Thickness of the RNFL around the optic disc was determined with 3.4 mm diameter-wide OCT scans. Average and segmental RNFL thickness values were compared among all groups. A correlation was sought between global indices of perimetry and RNFL thickness., Results: Of the 90 eyes enrolled (mean age of patients 52.32+/-10.11 years), the mean RNFL thickness was significantly less in ocular hypertensive (82.87+/-17.21 mm; P =0.008 and glaucomatous eyes (52.95+/-31.10 microm; P < 0.001), than in normals (94.26+/-12.36 microm). The RNFL was significantly thinner inferiorly in glaucomatous eyes (64.41+/-43.68 microm; P<0.001). than in normals (120.15+/-14.32 microm) and ocular hypertensives (107.87+/-25.79 microm; P<0.001). Ocular hypertensives had thinner RNFL in the nasal, inferior and temporal quadrants (P<0.001) when compared to normals. Global indices in ocular hypertensives on SWAP showed Mean Deviation (MD) of 5.32+/-4.49, Pattern Standard Deviation (PSD) 3.83+/-1.59 and Corrected Pattern Standard Deviation (CPSD) 2.84+/-1.85. The RNFL thickness could not be significantly correlated with global indices of visual fields in ocular hypertensives., Conclusion: Optical coherence tomography is capable of detecting changes at the level of RNFL in ocular hypertensive eyes with normal appearance of discs and W/W perimetry fields.