Cornea is a nonlinear viscoelastic tissue that presents different mechanical properties when tested under posterior and anterior pressure. The determination of the behavior under both forms of pressure could contribute to the construction of accurate finite element simulations of corneal behavior and the correction of tonometric IOP measurements. The difference in mechanical behavior between anteriorly and posteriorly loaded corneas in the study, although significant, could have been partly affected by the changes in microstructure possibly caused by changing corneal form to enable anterior loading.

We present a 49-year-old woman with nanophthalmos, white cataract, and malignant glaucoma in her left eye. The corrected distance visual acuity (CDVA) in that eye was hand motion, and the intraocular pressure (IOP) fluctuated between 28 mm Hg and 45 mm Hg with antiglaucoma medications. An unsutured sclerectomy combined with zonulectomy, hyaloidectomy, and anterior vitrectomy was performed. At 6 months postoperatively, the IOP was maintained at 12 mm Hg, the anterior chamber was deep, and the Snellen CDVA was 20/80. No intraoperative or postoperative complications were observed. The outcome in this case suggests that sclerectomy combined with phacoemulsification, zonulectomy, hyaloidectomy, and anterior vitrectomy is effective for the management of nanophthalmic patients with white cataract and malignant glaucoma.