Progressive Synechial Angle Closure From an Enlarging Soemmering Ring

New York Eye and Ear Infirmary, 310 E 14th St, Ste 304, New York, NY 10003. .
Archives of ophthalmology (Impact Factor: 4.4). 12/2011; 129(12):1631-2. DOI: 10.1001/archophthalmol.2011.344
Source: PubMed
11 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report an 84-year-old female patient who presented to our clinic with a complaint of low vision in her right eye. She described an occasional foreign body-like object around the pupil area. She had a history of extracapsular cataract surgery without an intraocular lens implantation 20 years ago. The patient underwent surgery to remove the foreign body-like object after conducting necessary investigations before surgery. The histopathological features of the specimen were consistent with a Soemmering ring. However, a Soemmering ring does not usually reduce vision unless it is dislocated, as in this case. We report this unusual case to show that ophthalmologists can encounter unexpected cases that present with complications as a result of previous cataract surgery after a lengthy period of time.
    International Ophthalmology 03/2013; 34(1). DOI:10.1007/s10792-013-9745-3 · 0.55 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We present a case of a pseudophakic woman with chronic angle-closure glaucoma. She had undergone uncomplicated bilateral phacoemulsification in 1994 with 21-diopter implants in the capsular bag. Fourteen years later, the right eye developed progressive angle closure with ocular hypertension, disc cupping and visual field defect. We observed a shallow anterior chamber, myopic shift, and closed angle, not openable on indentation gonioscopy. UBM revealed anteroposition of the ciliary body and a Soemmering's ring, with both appearing to contribute to the angle closure. After two incomplete iridotomies and one complete but blocked by the Soemmering's ring, a final UBM-guided iridotomy afforded a partial reopening of the angle, and satisfactory IOP control. The appearance and development of a Soemmering's ring after phacoemulsification are not always appreciated. It is common but usually asymptomatic. However, in some cases, when it is thick and/or located anteriorly, in the case of an anteroposition of the ciliary body (as in our case), it seems to cause direct pressure on the iris and pupillary block. Angle-closure glaucoma in pseudophakic eyes remains uncommon, the use of UBM is recommended, the role of a Soemmering's ring should be investigated, iridotomies must often be repeated, and long-term monitoring of pseudophakic patients remains necessary.
    Journal francais d'ophtalmologie 05/2013; 36(5):455–460. DOI:10.1016/j.jfo.2012.10.013 · 0.39 Impact Factor