A Soemmering’s ring is a postoperative finding characterized by a doughnut-shaped proliferation of residual lens epithelial cells and cortical fibers within the peripheral capsular bag. Formed when the anterior and posterior capsule leaflets fuse after cataract extraction, most notably in pediatric cases or after trauma, this sequestered ring of material can eventually cause secondary glaucoma, uveitis-glaucoma-hyphema (UGH) syndrome, or interfere with secondary IOL centration. During surgery to place a new IOL, the surgeon typically reopens the capsular bag by using micro-scissors to incise the fibrotic anterior capsule peripheral to the original opening. To remove the material, a dispersive viscoelastic is injected between the leaflets to “viscoexpress” and mobilize the ring into the anterior chamber. Once liberated, the dense material is fragmented using a two-handed technique or a phacoemulsification probe in a “slow-motion” setting to protect the endothelium. If the posterior capsule is compromised, an IOL scaffold or a small pupil can be used to prevent fragments from falling into the vitreous. Clearing this ring not only resolves mechanical irritation but also restores a clean capsular equator, allowing for secure “in-the-bag” fixation of the new lens.
