Ultrasound biomicroscopic analysis of iris profile changes with accommodation in pigmentary glaucoma and relationship to age

PURPOSE: To examine the effect of accommodation on iris profile in pigmentary glaucoma and its relationship to age. DESIGN: Interventional case series. METHODS: We measured change in iris profile with accommodation in 92 eyes of 92 patients with pigmentary glaucoma. RESULTS: Mean age was 42 years. Mean change in posterior iris excursion from nonaccommodated to accommodated state was 144.5 microm. (P < .001). Age was plotted against iris excursion with an estimated least-squares regression line. The estimated Pearson correlation coefficient was -0.60, (P < .001). Patients younger than 42 years of age had a mean change in excursion of 209.2 microm compared with 79.8 microm for those patients older than 42 years. (P < .001) CONCLUSION: This study found that there is a significant increase in posterior iris bowing in the accommodated state. Increasing age is associated with decreased posterior iris deviation. These findings add evidence to the theory of accommodation-induced reverse pupillary block in pigmentary glaucoma.