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Abstract #53609 Published in IGR 15-2
Chronic angle-closure glaucoma in a pseudophakic eye with Soemmering's ring and plateau iris: case report
Esmenjaud E; Rebollo OJournal Français d'Ophtalmologie 2013; 36: 455-460
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.
Centre d'ophtalmologie du Lez, 67, chemin de Fescau, 34980 Montferrier-sur-Lez, France. e.esmenjaud@wanadoo.fr
Full articleClassification:
9.3.3 Plateau iris syndrome (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
