Soemmering Ring In Anterior Chamber 20 Years After Initial Surgery

To report an unusual case of a Soemmering ring dislocated into the anterior chamber 20 years after cataract surgery.

Private practice Buenos Aires Argentina.

A 60-year-old patient presented with sudden decreased vision. She had type 1 diabetes and a history of cataract surgery twenty years earlier.

At the slit lamp examination, a Soemmering ring was observed luxated into the anterior chamber through the pupil. Visual acuity was hand motion. IOP was 13 mmHg, with no corneal edema or any other anterior chamber abnormalities. Fundus examination showed no significant changes; the IOL was in place, and the Soemmering ring could also be seen. Surgery was scheduled for the following day.

The procedure was performed under topical anesthesia, using bimanual irrigation and aspiration after injection of viscoelastic into the anterior chamber. The Soemmering ring was successfully aspirated with the aspiration handpiece, without the need for additional instruments. The IOL remained in place, and the incisions were sealed.

The patient recovered her previous uncorrected visual acuity 24 hours after surgery, and no corneal edema or IOP spike was observed.

Today, cataract surgery is increasingly performed with a refractive purpose, and younger patients are undergoing clear lens extraction. With the advent of advanced IOL technologies, spectacle independence has become a realistic goal, and patients in their 50s and even late 40s are electing to undergo clear lens surgery. Although not very common, Soemmering rings may become a more frequent long-term finding in the future, as life expectancy increases and lens surgery is performed at younger ages.

This case represents an unusual presentation, as Soemmering rings typically remain stable within the capsular bag and only rarely migrate into the anterior chamber.