Prevalence and clinical associations of relative anterior microphthalmos assessed with an optical biometer

Relative anterior microphthalmos (RAM) is a rare ocular condition characterized by disproportionately small anterior segments but normal axial length (corneal diameter < 11 mm and axial length > 20 mm). This study aimed to determine the prevalence of RAM and its association with glaucoma utilizing IOL Master 700 data (Carl Zeiss Meditec, Jena, Germany). A retrospective analysis was conducted of the biometric parameters of 6,407 eyes, and 115 cases of RAM were identified. The incidence of glaucoma was assessed, together with the outcomes of cataract surgery in cases of RAM with glaucoma. RAM prevalence was 1.8%. RAM patients had a higher incidence of glaucoma (26.1%), notably of the angle-closure subtype. Cataract surgery significantly reduced intraocular pressure in cases of RAM with glaucoma; however, RAM patients experienced a higher rate of surgical complications. RAM poses clinical challenges due to its association with glaucoma and increased surgical risks. This study emphasizes the importance of advanced diagnostic tools such as the IOL Master in tailoring interventions to optimize patient outcomes.