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True splitting (delamination) of the anterior lens capsule has been documented in glass blowers1 and patients who were not exposed to infrared irradiation.2,3 Partial splitting of the anterior lens capsule, giving a "double-ring" sign during continuous curvilinear anterior capsulorhexis, is documented herein for the first time.
Report of a Case.
An 86-year-old healthy woman underwent an uncomplicated, no-stitch, phacoemulsification cataract extraction of the left eye with implantation of a foldable silicone lens. During the initial anterior capsule puncture and raising of a flap at the 3-o'clock position with a 90° bent-tip 25-gauge needle, a line was noted parallel and peripheral to the edge of the capsulorhexis. The same needle was used to complete the continuous-tear curvilinear capsulorhexis for 360°, with the "double ring" evident for the full 360°. It was possible to guide the outer ring closer to the inner-ring margin of the capsulorhexis at the 9-o'clock position,
Braude LS, Edward DP. Partial Splitting of the Anterior Lens Capsule Giving a 'Double-Ring' Sign. Arch Ophthalmol. 1995;113(6):705-706. doi:10.1001/archopht.1995.01100060029017