Management of Uveitis-Glaucoma-Hyphema Syndrome Caused by Soemmering Ring Cataract: Case Report and Literature Review

Abstract

We describe a rare case of Soemmering’s ring-induced uveitis-glaucoma-hyphema (UGH) syndrome, caused by an undisplaced, in-the-bag intraocular lens (IOL) 16 years after implantation. The presenting symptoms were recurrent episodes of transient monocular vision loss, which prompted extensive unremarkable investigations. Ultrasound biomicroscopy (UBM) eventually revealed an enlarging Soemmering’s ring contacting the posterior iris and causing UGH syndrome. This is a unique case because the IOL haptics remained in the bag. Anterior vitrectomy, Soemmering’s ring extraction, IOL exchange to a 3-piece IOL, and implantation of a trabecular meshwork bypass microstent were performed. IOP control and both functional and structural stability were achieved long term. Soemmering’s ring-induced UGH syndrome should be on the differential of a patient with previous cataract surgery and elevated IOP complaining of visual disturbances. Early diagnosis with UBM and surgical intervention may provide optimal outcomes.