Glaucoma secondary to Peters' anomaly (PA) is an important factor affecting visual prognosis, but there are few reports on it. This study aimed to investigate the characteristics of glaucoma asso-ciated with PA and glaucoma surgery outcomes. This retrospective study included 31 eyes of 20 patients with PA. PA was classified into three stages: Stage 1, with a posterior corneal defect only; Stage 2, a corneal defect with iridocorneal adhesion; and Stage 3, a corneal defect with lens ab-normalities. The associations between glaucoma and anterior segment dysgenesis severity, visual prognosis, and glaucoma surgery outcomes were analyzed. Sixteen eyes of 10 patients developed glaucoma. Stage 1 PA had no glaucoma, 52% of Stage 2 had glaucoma, and 75% of Stage 3 had glaucoma. Of the 16 eyes with glaucoma, 11 underwent surgery. Eight of these 11 eyes achieved intraocular pressure (IOP) control. Five of the nine eyes that underwent trabeculotomy (TLO) succeeded, and none had corneal staphyloma. Three of the four eyes for which TLO was ineffective had corneal staphyloma (P=0.0331). Patients with PA are more likely to develop glaucoma as anterior segment dysgenesis progresses, and the effect of TLO is limited if corneal staphyloma is present.

To investigate switching from brimonidine and ripasudil, and brimonidine or ripasudil to a fixed combination of brimonidine and ripasudil and evaluate the associated efficacy and safety in glaucoma patients. Glaucoma patients undergoing treatment with at least brimonidine and ripasudil (n = 25) or treatment with at least brimonidine or ripasudil (n = 45) were evaluated in this retrospective study. After switching patients taking brimonidine and ripasudil, or brimonidine or ripasudil to a ripasudil/brimonidine fixed-combination ophthalmic suspension (RBFC), intraocular pressure (IOP), superficial punctate keratopathy (SPK) and conjunctival hyperemia were evaluated at baseline and at 4, 12 and 24 weeks. No significant differences in the IOPs were observed at any of the time points after switching from brimonidine and ripasudil to RBFC. However, at 4, 12 and 24 weeks, a significant decrease was observed in the mean baseline IOP from 17.0 ± 4.4 mmHg to 15.7 ± 3.2 mmHg (P < 0.01), 14.3 ± 3.4 mmHg (P < 0.01) and 14.4 ± 4.1 mmHg (P < 0.01), respectively, after switching from brimonidine or ripasudil to RBFC. No significant changes were noted for the SPK score or conjunctival hyperemia at any time points after switching to RBFC. Throughout the 24-week evaluation period, the IOP was maintained after switching from brimonidine and ripasudil to RBFC. However, there was a significant IOP decrease after switching from brimonidine or ripasudil to RBFC. These results demonstrate that RBFC is safe for use in the treatment of glaucoma patients.