title: Angle closure caused by a plateau-like iris associated with an enlarged Soemmering's ring: a case report.
abstract: BACKGROUND
  This study evaluated the anterior ocular segment in a pseudophakic eye with angle closure due to a plateau-like iris associated with Soemmering's ring, using ultrasound biomicroscopy (UBM) and anterior segment optical coherence tomography (AS-OCT).
  
  
  METHODS
  A 60-year-old woman was referred from a local clinic due to sudden-onset ocular pain and uncontrolled intraocular pressure (IOP) in the left eye, which was 56 mmHg after treatment with latanoprost, timolol, and dorzolamide eye drops. Fourteen years earlier, she developed acute primary angle closure. At that time, because the IOP remained elevated after a peripheral iridectomy, cataract extraction combined with goniosynechialysis was added. After the IOP decreased to within the normal range, a secondary intraocular lens was implanted outside the bag. On this admission, UBM and AS-OCT images showed angle closure caused by the combination of a plateau-like iris and contact between the mydriatic pupillary margin and enlarged Soemmering's ring. After adding 2 % pilocarpine four times a day, the mydriasis resolved slightly, and the IOP decreased to the normal range between 8 and 18 mmHg. AS-OCT images showed re-opening of the angle structure after treatment with 2 % pilocarpine.
  
  
  CONCLUSIONS
  The intraocular pressure and angle structure in eyes with a plateau iris after cataract extraction should be followed carefully.
authors.affiliation: Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan.
authors.forename: Fumika
authors.initials: F
authors.lastname: Kitamura
authors.affiliation: Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan. noel@da2.so-net.ne.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan.
authors.forename: Utako
authors.initials: U
authors.lastname: Kuroda
authors.affiliation: Department of Ophthalmology, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, Japan.
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Tanihara
mesh_terms: D005260:Female; D015812:Glaucoma, Angle-Closure / Q000209:etiology*; D006801:Humans; D007499:Iris Diseases / Q000150:complications*; D007905:Lens Diseases / Q000150:complications*; D008875:Middle Aged; D019591:Pseudophakia / Q000209:etiology*
keywords: Angle closure glaucoma; Pilocarpine; Soemmering’s ring