Late-onset malignant glaucoma associated with Soemmering's ring: A case report

Malignant glaucoma typically presents immediately after angle-closure surgery. However, late-onset malignant glaucoma can occur after various ocular procedures. This report describes the case of an African-American woman in her late 70s who developed malignant glaucoma 7 years after cataract surgery. She initially presented with signs of acute angle-closure glaucoma. Symptoms began a few days earlier with unilateral blurred vision and a dull orbital ache. The patient was initially managed with maximum aqueous humor suppressants. Imaging and ocular examination raised suspicion of malignant glaucoma, and a Soemmering's ring was noted on examination. Laser peripheral iridotomy was attempted in the operating room; however, definitive treatment involving iridozonulohyaloidectomy with vitrectomy was necessary. Patient intraocular pressure, vision, and examination findings improved following intervention, showing continuous postoperative improvements. This case highlights Soemmering's ring as a potential precipitant of malignant glaucoma as well as the effectiveness of iridozonulohyaloidectomy as a definitive treatment for pseudophakic malignant glaucoma.