title: [Chronic angle-closure glaucoma in a pseudophakic eye with Soemmering's ring and plateau iris: case report].
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.
authors.affiliation: Centre d'ophtalmologie du Lez, 67, chemin de Fescau, 34980 Montferrier-sur-Lez, France. e.esmenjaud@wanadoo.fr
authors.forename: E
authors.initials: E
authors.lastname: Esmenjaud
authors.forename: O
authors.initials: O
authors.lastname: Rebollo
mesh_terms: D000369:Aged, 80 and over; D002908:Chronic Disease; D002924:Ciliary Body / Q000473:pathology; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007499:Iris Diseases / Q000150:complications* / Q000473:pathology; D054120:Phakic Intraocular Lenses; D019591:Pseudophakia / Q000150:complications* / Q000473:pathology