Pseudophakic angle-closure from a Soemmering ring.
BACKGROUND
Report of three patients with pseudophakic angle-closure from a Soemmering ring. Three mechanisms of the Soemmering ring induced pseudophakic angle-closure in three patients were demonstrated by meticulous anterior segment examination and ultrasound biomicroscopic (UBM) analysis.


METHODS
In the first case, the Soemmering-capsule-IOL complex caused relative pupillary block similar to a phakic eye and was successfully treated with laser iridotomy alone. In the second case, an enlarged Soemmering ring provided posterior iris support in apposition to the anterior chamber angle. We performed a laser capsulotomy through the iridotomised hole. The last, a protruding Soemmering content causing absolute pupillary block became resolved after laser iridotomy and total Soemmering ring content removal.


CONCLUSIONS
Angle-closure in pseudophakic eyes is uncommon. Several causes have been reported in the literatures including Soemmering ring. This is the first report on three different mechanisms of Soemmering ring related angle-closure in pseudophakic eyes. Ultrasound biomicroscopic analysis plays a crucial role as a diagnostic tool.
Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. yanin.suwan@gmail.com.
Yanin
Y
Suwan
Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Bayasgalan
B
Purevdorj
Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chaiwat
C
Teekhasaenee
Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Wasu
W
Supakontanasan
Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Pornchai
P
Simaroj
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000209:etiology*; D006801:Humans; D007499:Iris Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D019591:Pseudophakia / Q000209:etiology*
Angle-closure; Cataract; Pseudophakic angle-closure; Soemmering ring; Ultrasound biomicroscopy