Background Although primary angle-closure glaucoma (PACG) mainly occurs in elderly people, diagnosis of PACG in young patients is not uncommon. So far, there is no article specialized on the ocular anatomical characteristics in these patients.In this study, ocular anatomical characteristics in young PACG patients are analyzed. Methods In this retrospective, comparative study, patients diagnosed with PACG and received ultrasound biomicroscopy (UBM) examination in our department were included. Patients were divided into two groups: a young group composed of patients ≤ 45 years and an old group composed of patients > 45 years. A-scan ultrasonography and ultrasound biomicroscopy (UBM) were used to measure ocular biometric parameters of patients in the two groups including axial length (AL), lens thickness (LT), central anterior chamber depth (ACD), anterior chamber width (ACW), angle opening distance 500 (AOD500), anterior chamber angle 500 (ACA500), iris thickness 1000 μm from the iris root (IT1000), iris thickness 500 μm from the iris root (IT500), trabecular-ciliary process angle (TCPA), trabecular-ciliary process distance (TCPD), scleral– ciliary process angle (SCPA), lens vault (LV), and pupil diameter (PD). Plateau iris (PI) and basal iris insertion were determined from UBM images, and the prevalence of PI and basal iris insertion were compared between the two groups. The incidence of postoperative malignant glaucoma (MG) was also determined in both groups and ocular anatomical predictors for the development of MG were evaluated in young PACG patients. Results One hundred fifteen patients were included into young group and 480 patients were included into old group. The young group had shorter TCPD, shorter AL, narrower TCPA, narrower SCPA thinner Lens compared to the old group. There were no significant differences in ACD, AOD 500, ACA500, LV, IT500, IT1000, PD or ACW between the two groups. The prevalence of PI was 22.6% in old group and 66.1% in young group (P < 0.001). More young PACG patients displayed basal iris insertion compared to old PACG patients (P < 0.001). 87 patients in the young group and 201 patients in the old group underwent trabeculectomy in our study. Among these patients, 21 young patients and 11 old patients developed MG after trabeculectomy (P < 0.001). Conclusions Shorter AL, more anteriorly positioned ciliary body, higher prevalence of PI may be responsible for the etiology of young PACG patients. Our results suggest that shorter AL, shorter TCPD and narrower TCPA may be predictors for development of MG in young PACG patients after trabeculectomy.

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Purpose. To determine the effectiveness and safety of selective laser trabeculoplasty (SLT) in young patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT). Methods. This was a retrospective clinical study. Fifty-six eyes from 56 young (age ≤ 40 y) patients with POAG or OHT treated with SLT were included. According to age, patients were divided into group 1 and group 2. Patients in group 1 were younger than 18 years old, and patients in group 2 were between 18 and 40 years old. Patients were evaluated before treatment and at 1 hour, 1 day, 1 week, 1 month, 3 months, 6 months, and 1 year after treatment. We also collected older patients (age ≥ 60 y) who received SLT during the same period for comparison at 1-year follow-up. Possible factors affecting the success of SLT, including baseline IOP, age, sex, diagnosis (POAG or OHT), and whether or not use of antiglaucoma medication before treatment, were analyzed. Results. SLT treatment produced significant reduction in IOP in the young patients with POAG or OHT during the 1-year follow-up period（P<0.05）. Mean IOP at 1 hour after SLT was lower in group 1 than in group 2 (P<0.01), but at other follow-up time points, IOP values were not different (P>0.05). IOP reduction and success rate were not significantly different between young and old patients at 1 year after treatment. IOP measurements over a 24-hour period were recorded before and after the SLT in 20 young adult patients. IOP values were significantly lower in the treated patients at all time points than at pretreatment (P<0.05), and 24-hour mean IOP, peak IOP, valley IOP, and fluctuation in IOP were also lower in SLT-treated patients (P<0.05). Baseline IOP was found as a predictor of SLT success in young patients (OR = 1.895, P=0.003), whereas age, gender, diagnosis, and whether or not use of antiglaucoma medication were not correlated with SLT success (P=0.725, P=0.750, P=0.061, and P=0.201, respectively). Conclusion. In this study, SLT was found as an effective and safe treatment for young patients with POAG and OHT. High baseline IOP predicted high SLT success.

PurposeTo identify the iris morphology-related factors for prediction of outcomes of excessively low vault (&lt; 100 μm) after Implantable Collamer Lens V4c (ICL V4c; STAAR Surgical) implantation.MethodsThis retrospective case-control study included 81 eyes from 2,080 patients who underwent ICL implantation. Twenty-seven eyes of 27 patients with excessively low vault (&lt; 100 μm) constituted the case group (excessively low vault group). Patients with vault (250 to 750 μm) were selected as the optimal vault group by matching anterior chamber depth, white-to-white distance and ICL size with cases with excessive low vault (&lt; 100 μm) at a proportion of 1:2. The preoperative biometric parameters and postoperative vault were recorded. Multiple linear regression analysis was performed to assess the relationship between the postoperative vault and various variables. Conditional logistic regression analysis was used to estimate the risk factors for excessively low vault.ResultsThe postoperative vault was associated with preoperative pupil diameter (PD), crystalline lens rise, iris concavity and the ratio of the iris concavity to chord length (P &lt; 0.05). The larger iris concavity increased risk of excessively low postoperative vault (&lt; 100 μm) (OR = 81.10; 95%CI = 2.87 to 2296.58; P = 0.01).ConclusionsEyes with obviously concave iris were associated with a higher rate of excessively low vault (&lt; 100 μm). Evaluation of iris morphology may provide significant information for predicting excessive postoperative vault.