Double-Ring and Double-Layer Sign of the Anterior Lens Capsule During Cataract Surgery

Novel method of assessing delamination of the anterior lens capsule using spectral-domain optical coherence tomography

“…Propensity for delamination in this region may be exacerbated by laser peripheral iridotomy, which is usually performed in the peripheral third of the iris. In a similar case report by Abe et al,7 the patient had also undergone laser peripheral iridotomy in the same eye with the double-ring sign. As the splits were only present unilaterally in both our patients, we postulate that they were related to the argon-YAG laser peripheral iridotomies.…”

“…Case series of splitting of the lens capsule with a double-ring sign seen at the capsular margins of a continuous curvilinear capsulorhexis during cataract surgery have been documented comprehensively in the literature 1–7. We compare the novel use of high-resolution spectral-domain optical coherence tomography (SD-OCT) devices to delineate the split.…”

Histopathological study of the anterior lens capsule with a double-ring sign

“…Shinjoreported the double-ring sign in 16 eyes during a 7-month period of performing cataract surgeries [5]. Abe reported one patient with the double-ring sign in one eye among 300 patients who underwent capsulorhexis [1]. We encountered the double-ring sign in 5.5% of eyes (5.4% were our patients) during continuous curvilinear capsulorhexis.…”

Age-Related True Exfoliation of the Lens Capsule: Phacoemulsification Surgery Results

“…In our series, the diagnosis of true exfoliation was made by recognizing the double-ring sign and/or the presence of a split or rolled-up anterior capsule, which was strongly associated with true exfoliation [ 1 , 5 , 6 , 9 , 10 , 11 ]. In 2 patients from our series, the anterior capsule had histological confirmation of the true exfoliation syndrome, with delamination and rolling up of the anterior capsule.…”

“…The presence of true exfoliation of the lens capsule typically increases the risk of capsule complications such as radial extension and radial tear [ 9 , 11 , 12 ]. In our case series, all cases of age-related true exfoliation syndrome had a good outcome from phacoemulsification and capsular implantation of the intraocular lens.…”