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Pseudophakic angle-closure from a Soemmering ring.

Yanin Suwan1, Bayasgalan Purevdorj2, Chaiwat Teekhasaenee2

  • 1Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. yanin.suwan@gmail.com.

BMC Ophthalmology
|June 19, 2016
PubMed
Summary

Pseudophakic angle-closure caused by a Soemmering ring is rare. This report details three distinct mechanisms of Soemmering ring-induced angle-closure in pseudophakic eyes, highlighting ultrasound biomicroscopy

Keywords:
Angle-closureCataractPseudophakic angle-closureSoemmering ringUltrasound biomicroscopy

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Area of Science:

  • Ophthalmology
  • Biomedical Optics

Background:

  • Pseudophakic angle-closure glaucoma is an uncommon but serious complication following cataract surgery.
  • The Soemmering ring, a remnant of the lens capsule, has been implicated as a cause of angle-closure in pseudophakic eyes.
  • Understanding the mechanisms by which a Soemmering ring induces angle-closure is crucial for effective management.

Observation:

  • Three distinct cases of pseudophakic angle-closure secondary to a Soemmering ring are presented.
  • Detailed anterior segment examination and ultrasound biomicroscopy (UBM) were utilized for diagnosis.
  • Case 1: Soemmering-capsule-intraocular lens (IOL) complex caused relative pupillary block, treated with laser iridotomy.
  • Case 2: Enlarged Soemmering ring provided iris support, leading to angle-closure; treated with laser capsulotomy.
  • Case 3: Protruding Soemmering content caused absolute pupillary block, resolved by laser iridotomy and surgical removal.

Findings:

  • This study elucidates three unique mechanisms of Soemmering ring-induced angle-closure in pseudophakic eyes.
  • Ultrasound biomicroscopy (UBM) proved essential in differentiating the specific mechanisms of angle-closure.
  • The findings demonstrate the varied ways a Soemmering ring can obstruct aqueous humor outflow.

Implications:

  • This report expands the understanding of pseudophakic angle-closure etiologies related to the Soemmering ring.
  • Accurate diagnosis using UBM is vital for selecting appropriate treatment strategies.
  • Timely intervention can prevent vision loss in patients with Soemmering ring-induced angle-closure.