To report a case of cyclodialysis cleft closure following ab interno suprachoroidal spacer implantation (AlloFlo) resulting in a severe postoperative intraocular pressure (IOP) spike. An 80-year-old woman with uncontrolled open-angle glaucoma in the right eye and intolerance to multiple medications declined incisional glaucoma surgery due to scarring risk and eyelid anatomy limiting bleb management. She underwent ab interno cyclodialysis creation and placement of 2 suprachoroidal spacers composed of donor scleral tissue [AlloFlo, White Plains, NY]. On postoperative day 1, IOP decreased from 34 to 10mmHg with a quiet anterior segment and visible spacers on gonioscopy. The early postoperative course was unremarkable. At postoperative week 3, she presented with ocular pain and an IOP of 60mmHg despite anterior visualization of the spacers. Serial anterior chamber paracenteses and maximal medical therapy provided only transient pressure reduction. Ultrasound biomicroscopy ultimately demonstrated posterior closure of the cyclodialysis cleft without a posterior fluid lake. The patient subsequently underwent urgent tube shunt implantation. At 9 months postoperatively, vision was preserved, and IOP was controlled on 2 topical agents. Cyclodialysis cleft closure is a potential failure mechanism following suprachoroidal spacer implantation and may result in abrupt and marked IOP elevation. Careful patient selection, vigilant postoperative monitoring, and early imaging with ultrasound biomicroscopy are essential to guide timely management.

Suprachoroidal (SC) injection enables targeted posterior drug delivery but relies on subjective tactile feedback to confirm depth. This can require multiple passes or cause intravitreal delivery, increasing patient discomfort and complication risk. This study evaluates whether ultrasound biomicroscopy (UBM) can guide custom needle selection based on scleral thickness to improve first-pass SC injection success. Ten ex vivo porcine eyes underwent pre-injection UBM to measure scleral thickness. Custom-length needles (0.5-1.5 mm) were selected accordingly. SC injections were performed under UBM guidance, with imaging confirming entry and injectate spread. UBM confirmed successful SC injection in all specimens, with hypoechoic separation between sclera and choroid. Post-injection, scleral thickness increased significantly (1.13 ± 0.13 mm to 2.28 ± 0.19 mm, P < .0001), validating drug delivery. UBM-guided needle selection enables accurate SC injection and may reduce failed attempts. This approach could enhance the efficacy of SC delivery and support broader clinical use across posterior segment diseases.

To report a rare case of unilateral secondary angle closure in a young male with bilateral nanophthalmos caused by spontaneous supraciliary and choroidal effusion, highlighting the diagnostic role of multimodal imaging and the importance of individualized management. A 33-year-old male, a known case of hyperopia in both eyes, presented with gradual visual loss in both his eyes. Examination revealed asymmetric anterior chamber depth with shallowing in right eye (RE) > left eye (LE), bilateral short axial lengths, and a 360° choroidal detachment in the RE, while the fellow eye remained clinically stable. Ultrasound biomicroscopy (UBM) confirmed supraciliary effusion in the affected eye, explaining the secondary angle closure mechanism. Despite initial conservative management with oral & topical steroids, he had persistent choroidal effusion and was advised surgical intervention. He underwent single quadrant posterior sclerostomy, which resulted in significant resolution of effusions with anatomical and visual improvement. This case highlights the importance of considering spontaneous supraciliary effusion as a possible cause for unilateral secondary angle closure in short eyes. Underscores the importance of early multimodal imaging and timely posterior sclerostomy to preserve vision when medical therapy is unsuccessful. Asymmetrical angle closure could be a clinical clue to detect uveal effusions in nanophthalmos.

Suprachoroidal injection enables targeted posterior segment drug delivery with reduced anterior segment exposure. Off-label use of the dexamethasone implant (Ozurdex) via the suprachoroidal route may benefit patients with macular edema who have contraindications to intravitreal therapy. This article aims to introduce a two-step surgical technique for suprachoroidal Ozurdex injection and reports its feasibility and short-term outcomes in an illustrative case. A custom‑made injector assembled from a 26‑gauge hypodermic needle and an intravenous catheter. The technique involves: (1) injection of 0.3mL sodium hyaluronate viscoelastic into the suprachoroidal space at 4.0mm posterior to the limbus; (2) injection of the dexamethasone implant through the same site. The technique was performed in a 37‑year‑old pregnant woman at 24 weeks of gestation with vitreous hemorrhage and macular edema secondary to proliferative diabetic retinopathy in the left eye immediately following pars plana vitrectomy. Main outcomes included feasibility, safety, best‑corrected visual acuity (BCVA), intraocular pressure (IOP) and imaging findings on ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT). The procedure was completed without intraoperative complications. UBM at postoperative week 1 confirmed Ozurdex within an anechoic suprachoroidal space, which resolved by week 12. BCVA improved from decimal 0.2 (Snellen 4/20) at baseline to 0.4 (20/50) at 12 weeks. IOP remained stable (21-23 mmHg), with no cataract progression or significant IOP elevation. OCT showed resolution of intraretinal cysts. This two-step technique for suprachoroidal Ozurdex delivery using a custom‑made injector with viscoelastic pre‑injection is feasible and showed no major safety concerns in this case. It may provide an alternative delivery method for selected patients with non‑infectious macular edema who have relative contraindications to intravitreal anti‑vascular endothelial growth factor (VEGF) or corticosteroid injections. Further studies are needed to establish safety and efficacy.

Limbal corneal dermoids might invade the cornea at various depths, ranging from superficial lesions on the epithelium to deep lesions penetrating the entire corneal thickness and adjacent sclera. The aim of this report was to describe a limbal corneal dermoid with scleral ectasia at the posterior margin, requiring more complex surgical procedures. Ultrasound biomicroscopy (UBM) examination was used to identify posterior scleral ectasia and ciliary body prolapse; corneal limbal dermoid was treated with excision and eccentric anterior lamellar keratoplasty (ALK). A 28-year-old woman presents with a limbal corneal dermoid in her left eye. It has been growing since her birth, and recently, it became more prominent. Her best-corrected visual acuity was 20/70, and there was an amelanotic vascularized yellowish limbal lesion superotemporally, measuring 14 × 14 × 4.2 mm. The cornea was involved between the 12 and 3 o'clock meridians with surrounding scarring. An intralesional cavity-like area with possible intraocular communication through a scleral break was detected by UBM. During the surgery, a scleral protrusion, indicating significant thinning of the sclera, was noted. Excision of the lesion and eccentric ALK were performed. After 51 months of follow-up, best-corrected visual acuity was 20/60; there was residual corneal scarring superonasally on examination. This case highlights the potential utility of UBM in identifying associated congenital abnormalities in the limbal corneal dermoid, and combined excision and reconstruction with eccentric ALK may be considered a potential surgical approach.

Comment on: Multimodal deep learning for predicting postoperative vault and selecting implantable collamer lens sizes using AS-OCT and ultrasound biomicroscopy images.

Percussion massage guns (PMGs) have gained widespread popularity for muscle recovery; however, standardized safety guidelines for application to anatomically vulnerable regions are lacking. Previously reported PMG-associated ocular injuries have been limited to unilateral or mild bilateral involvement. We report the first documented case of bilateral anterior lens luxation with secondary glaucoma strongly associated with self-application of a PMG to closed eyelids. A 62-year-old Chinese male with type 2 diabetes mellitus and bilateral meibomian gland dysfunction presented with progressive visual decline and headache for 20 and 10 days, respectively, beginning approximately 7 days after discontinuing self-application of a PMG to closed eyelids (medium speed, 30-33Hz; 10min per session, 2-3 times daily for 3 consecutive days) used to relieve ocular dryness. Visual acuity was 0.12 OD and 0.2 OS, with intraocular pressure 51 mmHg OD and 49 mmHg OS. Ultrasound biomicroscopy revealed bilateral anterior lens luxation with 360° zonular dehiscence and complete angle closure. Hereditary, pseudoexfoliative, and biometric causes (including microspherophakia and phacomorphic glaucoma) were considered unlikely. Both eyes underwent sequential 25-gauge pars plana vitrectomy with lensectomy and closed four-point scleral fixation of a posterior chamber intraocular lens. At the latest follow-up (12 months postoperatively), best-corrected visual acuity was 1.0 OD and 0.8 OS, intraocular pressure was normal without antiglaucoma medication, and no glaucomatous optic neuropathy was detected on RNFL OCT. PMG application to the eyelids may be associated with severe bilateral ocular injury, including complete zonular dehiscence and secondary glaucoma, particularly in eyes with predisposing factors such as age-related zonular weakness or diabetes-related extracellular matrix changes. Manufacturers should incorporate explicit safety warnings against periorbital use. Clinicians should proactively guide diabetic patients with dry eye disease toward appropriate ophthalmic care to prevent harmful self-treatment.

Systemic lupus erythematosus (SLE) uncommonly presents with ocular manifestations as the initial feature. Uveal effusion syndrome (UES) is typically described in eyes with nanophthalmos and scleral abnormalities. This case is noteworthy for two reasons. First, the patient had normal axial length and no marked diffuse scleral thickening on ultrasound biomicroscopy(UBM), with a massive annular uveal/suprachoroidal effusion resembling a type III UES-like phenotype; however, concurrent active SLE, hypoalbuminaemia and polyserositis suggested a secondary systemic trigger. Second, ocular recovery appeared to accelerate after periocular corticosteroid therapy, despite inadequate response to systemic immunosuppression. A 38-year-old woman presented with three days of bilateral ocular pain and visual deterioration. Initial examination revealed intraocular pressure of 38.7 mmHg in the right eye and 32.7 mmHg in the left, shallow anterior chambers, and axial length of 21.85mm bilaterally. Bilateral angle-closure glaucoma was diagnosed, and laser peripheral iridotomy was performed along with topical antiglaucoma agents and corticosteroids. One week later, systemic symptoms including fever and polyarthralgia developed. Laboratory tests showed strongly positive autoimmune markers (ANA: antinuclear antibody, ANSA༚anti-nucleosome antibody, ARPA༚anti-ribosomal P protein antibody), low complement levels (C3༚complement 3, C4༚complement 4). Inflammatory markers were elevated (CRP༚C-reactive protein 84.08mg/L, ESR༚erythrocyte sedimentation rate 83mm/h), severe hypoalbuminaemia (27.4g/L). Imaging revealed pleural, pericardial, and peritoneal effusions. Active SLE with polyserositis and lupus nephritis was diagnosed. Intravenous methylprednisolone, cyclophosphamide, hydroxychloroquine and telitacicept were initiated. However, ultrasonography showed progressive 360-degree annular choroidal detachment with anterior displacement of the lens-iris diaphragm. Bilateral periocular triamcinolone acetonide 20mg was administered, followed by periocular dexamethasone 5mg. Choroidal detachment rapidly resolved, anterior chamber depth increased from 1.57mm to 2.93mm, and the retina reattached spontaneously. One month later, best-corrected visual acuity improved from 20/500 to 20/50 in both eyes, and intraocular pressure normalised. This case illustrates that systemic serous leakage in SLE can cause massive suprachoroidal effusion with secondary angle-closure glaucoma, even in eyes with normal axial length. Periocular corticosteroid therapy may serve as a useful adjunct by increasing local ocular drug exposure and promoting fluid resorption.

To describe a nonsurgical treatment for superficial corneal epithelial inclusion cysts (CEICs) in dogs and to characterize their clinical and diagnostic features using ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT). 4 client-owned dogs with superficial CEICs. Complete ophthalmic examinations and diagnostic imaging using UBM and/or OCT were performed on smooth, fluctuant, painless masses protruding from vascularized corneas. For superficial CEICs, needle lancing was performed under topical anesthesia. All dogs had been previously managed for keratoconjunctivitis sicca. Ultrasound biomicroscopy or OCT revealed superficial intrastromal cystic lesions surrounded by hyperechoic or hyper-reflective stroma, consistent with CEICs. All cysts were located within vascularized corneal stroma, with sufficient posterior stromal thickness and intact Descemet membrane beneath the cysts. Among 6 initially identified cysts, 1 ruptured spontaneously following trauma and was no longer detectable at reexamination. One cyst was excised by superficial keratectomy, and histopathologic examination confirmed CEIC; this cyst subsequently recurred. The remaining 4 cysts were intentionally treated by needle lancing using a 26-gauge needle under topical anesthesia. Cytologic examination of the drained material revealed predominantly extracellular matrix and epithelial cells without evidence of infection, supporting the diagnosis of CEIC. Topical anti-inflammatory agents and antibiotics were prescribed after lancing. None of the lanced cysts recurred during a follow-up period of 17 to 62 months. Needle lancing may represent a safe, simple, and effective treatment option for superficial vascularized CEICs in dogs. Advanced diagnostic imaging, such as UBM/OCT, may aid in determining cyst depth and guiding treatment selection.

To assess the repeatability of measuring the corneal diameter (white-to-white, WTW) using Sirius and IOLMaster 700 in myopic eyes, to evaluate their consistency and relationship with sulcus-to-sulcus (STS) and angle-to-angle (ATA). This retrospective study enrolled 58 volunteers with myopia (116 eyes). Each subject was evaluated using Sirius, IOLMaster 700 and ultrasound biomicroscope (UBM) for parameters which included WTW, STS, and ATA. STS referred to horizontal STS (STSH) and vertical STS (STSV), ATA contained horizontal ATA (ATAH) and vertical ATA (ATAV). The intra-device and intra-operator repeatability was assessed using the within-subject SD (Sw), precision, intrasession test-retest variability (repeatability), coefficient of variation (CoV), intraclass correlation coefficient (ICC) and Cronbach's coefficient Alpha (CoA). Bland-Altman plots were used to analyze the agreement between WTW and STS/ATA at different meridians. The correlation among ocular parameters was assessed by Spearman correlation analysis. The ocular parameters with normal distribution were used to analyze the multiple linear regressions of STS at different meridians. Curve fitting was used to analyze the relationship between STS and WTW at different meridians, separately. Akaike information criterion (AIC), Bayesian information criterion (BIC) and adjusted coefficient of determination (adjusted R2) were used to assess Goodness of fit (GOF). Three repeated measurements of WTW by Sirius and IOLMaster 700 showed no statistically significant discrepancies between the data (F = 0.306; 2.469, P > 0.05), and the difference between the data of paired t-tests of the mean values of WTW measured by each instrument was statistically significant (t= -2.894, P < 0.01). The Sw, precision, repeatability, CoV, ICC, CoA values for WTW measured by Sirius and IOLMaster 700 were (0.027, 0.054, 0.076, 0.232%, 0.981, 0.993) and (0.079, 0.155, 0.219, 0.666%, 0.980, 0.993), respectively. This trial demonstrated by Bland-Altman plots that the 95% LoA (Limits of agreement) for concordance between WTW measured by Sirius (WTWS), WTW measured by IOLMaster 700 (WTWI), STSH, STSV, ATAH and ATAV were beyond clinically acceptable limits. WTWS and WTWI had a moderate negative correlation with Kf (r=-0.39;-0.45, P<0.01) and Ks (r=-0.38;-0.39, P<0.01). Inversely, WTWS and WTWI had a weak to moderate positive correlation with ACD(r = 0.33, P<0.01; r = 0.20, P<0.05), AL(r = 0.25; 0.35, P<0.01), STS(P<0.01) and ATA(P<0.01) at different meridians, WTWS had a high positive correlation with WTWI (r = 0.76, P<0.01). Similarly ATAH had a high positive correlation with ATAV (r = 0.76, P<0.01). Through multiple linear regression analysis, the prediction equation of STSH was STSH=7.098- 0.357xSE+0.281xACD-0.201 xKf+0.307xWTWS, the prediction equation of STSV was STSV=7.710-0.289xIOP-0.336xSE+0.359xACD-0.203xKf+0.263xWTWS, the Adj. R2 were 0.391 and 0.423, respectively. The linear equation between STSH and STSV was STSV=2.765+0.804xSTSH, and the Adj. R2 was 0.486. The curve fitting suggested that the optimal curve model between WTWS and STSH was Logistic (AIC=-161.622, BIC=-148.399 and Adj. R2=0.226), the optimal curve model between WTWI and STSH was also Logistic (AIC=-153.969, BIC=-140.747 and Adj. R2=0.174), the curve fit between WTW and STSV was poor, the optimal curve model between STSH and STSV was Extreme (AIC=-180.337, BIC=-167.115 and Adj. R2=0.501). The repeatability of WTW measured by Sirius and IOLMaster 700 was satisfactory. The WTW measured by IOLMaster 700 was bigger than the WTW measured by Sirius. The parameters of WTWS, WTWI, STSH, STSV, ATAH and ATAV were inconsistent with each other, they were not clinically interchangeable. Using WTWS and WTWI to predict STSH may be more appropriate for categorical studies. It was recommended to use vertical corneal diameter to study STSV.

The study aimed to accurately measure anterior and posterior chamber parameters in ultrasound biomicroscopy (UBM) images and to quantify their relationship with intraocular pressure (IOP), axial length (AL) and lens thickness (LT), enhancing the understanding of primary angle-closure disease. UBM images of 135 patients with primary angle-closure glaucoma(PACG) and 30 healthy individuals were analyzed. The Level set method was used to measure anterior chamber depth (ACD) and posterior chamber area (PCA). Relative error and intraclass correlation coefficient (ICC) were used to assess the accuracy and consistency of these measurements compared to the ground truth. IOP, AL and LT were also measured, and the relationships between ACD, PCA, IOP, AL and LT were explored using Spearman correlation analysis. The Level set method yielded highly accurate measurements of ACD and PCA with low Relative errors and high ICC values. Spearman correlation analysis revealed that PCA was significantly positively correlated with both AL (R = 0.398, p = 0.002) and LT (R = 0.255, p = 0.006). In contrast, no statistically or clinically significant associations were found for the remaining parameter pairs (e.g., ACD-IOP, PCA-IOP), all of which showed |R|<0.2 and P > 0.05. The Level set method proves to be a highly accurate and consistent technique for UBM image analysis, boosting measurement efficiency and reproducibility. The significant correlations of PCA with AL and LT offer new insights into the anatomical complexity of angle-closure disease, emphasizing the posterior chamber as a critical dimension for further exploration.

IntroductionIn dogs, intraocular pressure (IOP) responses to topical atropine administration vary, and the anatomical basis for this variability remains unclear.Materials and methodsUsing ultrasound biomicroscopy (UBM), anterior segment morphology was assessed in 52 eyes from 27 clinically normal dogs before and 20 minutes after atropine administration (post-AT).ResultsThe mean change in IOP was small, but responses varied across eyes. Approximately 29% showed increases considered clinically relevant. Eyes were categorized into a high group (≥4 mmHg increase) and a stable group (<4 mmHg change) according to post-AT IOP change. Ciliary cleft area (CCA) increased significantly in the stable group and was accompanied by posterior-outward displacement of the ciliary body. In the high group, CCA tended to decrease, with relative anterior displacement of the ciliary body, although these changes were not consistently significant across parameters. In contrast, traditional anterior chamber angle parameters did not differ between groups.DiscussionHeterogeneous post-AT IOP responses appear to be associated with group-dependent differences in ciliary body configuration and ciliary cleft morphology. Variation in these structures may reflect underlying anatomical factors associated with IOP variability. UBM-based assessment may help interpretation of atropine-induced IOP changes.

Ocular ultrasonography is a key imaging modality when the posterior segment cannot be directly visualised by ophthalmoscopy. Image quality and interpretation are operator-dependent. Thus, good technique and understanding of the strengths and limitations of the different ultrasonography modalities e.g. A-scan (time-amplitude), B-scan (brightness), doppler and ultrasound biomicroscopy are valuable, especially in complex cases with diagnostic uncertainty. This article discusses the practical applications of ultrasonography in the diagnosis and management of common vitreoretinal emergencies (vitreous haemorrhage, retinal detachment and endophthalmitis) and complications of anterior segment surgery (choroidal effusion, suprachoroidal haemorrhage, malpositioned or dislocated lens).

To evaluate the surgical efficacy and functional outcomes of gonioscopy-guided transscleral direct cyclopexy (GTS direct cyclopexy) for repairing traumatic cyclodialysis clefts. This study included 20 eyes of 20 patients with traumatic cyclodialysis. GTS direct cyclopexy was performed using a curved needle with 10 - 0 polypropylene suture to close the cleft, with gonioscopy guidance for precise localization and closure confirmation. Additional procedures such as vitrectomy were performed as needed. Clinical data, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), and ultrasound biomicroscopy (UBM) findings, were collected preoperatively and at regular follow-up visits. Statistical analyses were performed using the Wilcoxon matched-pairs signed-rank test. Cyclodialysis closure was achieved in 19 of 20 eyes (95%) after a single GTS direct cyclopexy. The median extent of cyclodialysis was 60° (IQR: 34°-113°). BCVA significantly improved from 1.74 ± 0.98 logMAR preoperatively to 0.90 ± 0.69 logMAR at 6 months postoperatively (p = 0.002). IOP increased from a mean of 6.1 ± 2.8 mmHg to 12.63 ± 3.60 mmHg at 6 months (p = 0.0007). Postoperative IOP spikes were observed in 4 patients (20%) but were managed successfully. No cataracts related to the surgery were reported. GTS direct cyclopexy is a safe, minimally invasive, and repeatable for repairing traumatic cyclodialysis clefts.

To evaluate the effect of varying light intensity on geometric iridocorneal angle (ICA) and ciliary cleft (CC) parameters using ultrasound biomicroscopy (UBM) in normal canines. Twenty clinically normal adult purpose-bred Beagles (40 eyes). All dogs underwent UBM of the CC at two locations (dorsal and temporal) in each eye under dark (< 1 lx), dim (~40 lx), and bright (> 1500 lx) light conditions. The following parameters were measured: geometric ICA, width of CC entrance, width of mid-CC, and length of CC. Digital color and infrared photographs were obtained to allow for pupil diameter measurement under each light condition. Increasing light intensity resulted in significant decrease in the geometric ICA (dark: 47.27° ± 11.09°; dim: 40.48° ± 9.71°; bright: 26.72° ± 7.63°; p = 0.0001) with marginal effect on the width of CC entrance (dark: 0.25 ± 0.04 mm; dim: 0.27 ± 0.06 mm; bright: 0.28 ± 0.08 mm; p = 0.0548), and no effect on width of mid-CC, or length of CC. Regardless of light intensity or laterality of eye, geometric ICA and width of CC entrance were significantly greater dorsally (ICA: 39.82° ± 12.67° dorsal vs. 36.5° ± 12.8° temporal; CC entrance: 0.28 ± 0.07 mm dorsal vs. 0.26 ± 0.06 mm temporal; p = 0.0003 respectively) and CC length was significantly greater temporally (2.36 ± 0.28 mm temporal vs. 2.2 ± 0.27 mm dorsal; p = 0.0028). Aside from the geometric ICA, varying light intensity does not significantly impact CC measurements. ICA and CC measurements varied by quadrant. The authors recommend performing UBM of the CC in dim light conditions as this is most applicable to clinical settings and subjectively provided the greatest image quality.

To develop a deep-learning model capable of measuring essential anterior segment (AS) parameters derived from preoperative ultrasound biomicroscopy (UBM) images of candidates for implantable collamer lens (ICL) surgery. Tianjin Medical University Eye Hospital, Tianjin, China. Cross-sectional retrospective study. A dataset comprising 1,480 preoperative panoramic UBM images taken from 638 eyes of 320 subjects was collected and was divided into training and testing subsets at a proportion of 7:3. Using the YOLOv8-pose algorithm, the model identified ten anatomical key point coordinates and computed six relevant AS parameters. Both manual and anterior segment optical coherence tomography-based non-contact measurements served as reference standards for evaluating the model's accuracy. The relationship between postoperative vault and preoperative parameters measured by the model was analyzed using multiple linear regression. On the test dataset, the model achieved an intraclass correlation coefficient (ICC) exceeding 0.978, with a mean Euclidean distance of 67.65 ± 54.25μm across all point locations. The ICC values for anterior chamber depth (ACD), pupil diameter, and sulcus-to-sulcus distance were above 0.980 (95% CI: 0.975 to 0.985), with average relative error below 1.7%. Additionally, postoperative vault at one month was significantly correlated with model-measured parameters, including crystalline lens rise, iris concavity, and ACD (P < 0.001). This study introduces a robust program capable of quantitatively measuring AS parameters with accuracy comparable to that of experienced ophthalmologists. The findings provide valuable guidance for ICL sizing and vault prediction.

Nonpupillary block mechanisms are associated with larger postoperative peripheral anterior synechiae (PAS) extent at 1-year follow-up compared with pupillary block mechanisms in primary angle-closure disease (PACD). To evaluate the impact of preoperative angle closure mechanisms on the surgical outcomes of phacoemulsification and intraocular lens implantation (PEI) combined with VGP in PACD patients with cataracts. This prospective cohort study enrolled 56 patients (68 eyes) with PACD and cataracts. Participants were classified into pupillary block (PB) and nonpupillary block (Non-PB) groups based on the anatomic characteristics of angle closure shown in preoperative ultrasound biomicroscopy imaging. Primary outcomes included peripheral anterior synechiae (PAS) extent, intraocular pressure (IOP), and number of IOP-lowering medications over a 12-month follow-up period. Both groups showed significant reductions in PAS extent at the end of surgery compared with the baseline. At 6 and 12 months postoperatively, the Non-PB group exhibited significantly larger PAS extent compared with the PB group ( P =0.025 and 0.017, respectively). Both groups demonstrated significant IOP reduction and decreased use of IOP-lowering medications postoperatively, with no significant differences between groups. The overall complete and qualified success rates at 12 months were 71.6% and 98.5%, respectively, with no significant difference between groups. Non-PB mechanisms are associated with larger postoperative PAS extent at 1-year follow-up compared with PB mechanisms, emphasizing the importance of comprehensive preoperative angle closure mechanisms assessment in predicting and potentially minimizing PAS progression for enhanced long-term surgical efficacy in PACD treatment.

This study consisted of an in vivo experiment with the goal of performing instrumental evaluation of the position of a novel anti-glaucoma intrascleral implant. This in vivo study was conducted on 5 Chinchilla rabbits (n=5). The main group included 5 right eyes that underwent glaucoma surgery with implantation of the device. The comparison group consisted of 5 left eyes that underwent glaucoma surgery without implant placement. Animals in both groups were followed up for 3 months with biomicroscopy, ultrasound biomicroscopy, and optical coherence tomography (OCT) of the surgery area. At the end of the observation period, the rabbits were removed from the experiment for further research. The developed intrascleral implant maintained correct position and was clearly visualized within the scleral tissue in animals of the main group throughout the entire observation period (up to 3 months). The new anti-glaucoma intrascleral implant made of polymethylmethacrylate is promising for further research.

Axenfeld–Rieger syndrome (ARS) is a rare developmental disorder characterized by anterior segment dysgenesis and frequently associated with glaucoma. We report a late incidental diagnosis of ARS in a 59-year-old patient without ocular hypertension or glaucomatous optic neuropathy. The patient presented with bilateral anterior segment abnormalities, including posterior embryotoxon, iris stromal hypoplasia, and iridocorneal angle dysgenesis, associated with craniofacial anomalies and severe bilateral sensorineural hearing loss. Multimodal imaging using anterior segment optical coherence tomography and ultrasound biomicroscopy revealed significantly narrowed angles with reduced angle opening distance (AOD500), confirming structural dysgenesis. Despite these marked anatomical abnormalities, intraocular pressure and optic nerve evaluation remained within normal limits. This case illustrates the phenotypic variability of ARS and demonstrates that significant structural abnormalities may exist without glaucoma, even in late adulthood. Lifelong ophthalmologic follow-up remains essential due to the potential risk of delayed glaucoma onset.

Application of ultrasound biomicroscopy in ocular trauma caused by chestnut-burr spines.