Glued IOL scaffold can be used to manage Soemmering’s ring

Soemmering’s ring was first described by D.W. Soemmering and is considered to be a type of regenerating lens substance that has a peripheral disposition and often goes unrecognized unless it is centrally dislocated or the pupil is widely dilated. The incidence of Soemmering’s ring formation is higher in pediatric cases after cataract surgery. Retention of lens fibers between the anterior and posterior capsules is considered to be the possible etiology. The adhesions of the anterior and posterior capsules prevent the exposure of these lens fibers to the aqueous and the surrounding environment, promoting uninhibited growth of lens fibers.

Removal of Soemmering’s ring is essential followed by proper placement of an IOL because the presence of Soemmering’s ring may induce an IOL tilt in addition to occupying the space in the capsular bag. Various procedures and techniques have been described for the management of Soemmering’s ring. Glued IOL scaffold is a technique described by us for managing a posterior capsule rupture with non-emulsified nuclear fragments in the presence of inadequate capsular or iris support. After levitation of the nuclear fragments in the anterior chamber, a three-piece foldable IOL is injected beneath the lenticular fragments and a glued IOL procedure is performed. The pre-placed IOL acts as a scaffold and allows safe emulsification of the nuclear fragments. In cases of Soemmering’s ring with associated posterior capsule rupture, we use the glued IOL scaffold procedure for safe emulsification of Soemmering’s ring material.

Click here to read the publication exclusive, Complications Consult, published in Ocular Surgery News U.S. Edition, February 10, 2015.