Utility of Ultrasound Biomicroscopy in Pachyphakia, Microcornea, and Angle Closure

To describe the case of a young adult patient with a history of laser treatment for threshold retinopathy of prematurity, presenting with pachyphakia, microcornea, and acute angle-closure glaucoma.

A single case was observed.

The patient presented with reduced vision secondary to acute angle closure, with an intraocular pressure (IOP) of 60 mm Hg in the left eye. A surgical iridectomy resulted in immediate deepening of the anterior chamber and IOP normalization, though the anterior chamber remained shallow. Postoperatively, visual acuity returned to baseline, and IOP remained in the normal range. Ultrasound biomicroscopy after iridectomy demonstrated a persistently shallow anterior chamber secondary to pachyphakia. Phacoemulsification was performed 1 year later. Postoperative ultrasound biomicroscopy revealed normalization of anterior chamber anatomy.

Patients with pachyphakia, microcornea, and acute angle-closure glaucoma are at risk for both acute and chronic angle-closure glaucoma and must be monitored closely. Ultrasound biomicroscopy can be used to supplement clinical examination of angle closure.