Clinical-Medical Image - International Journal of Clinical & Medical Images (2021) Volume 8, Issue 11
Author(s): Jonathan K. Y. Ng*, and Habiba Saedon
An 82-year-old lady with a past history of left vitrectomy, phacoemulsification and intraocular lens 3 years earlier for a macular hole attended for her right eye cataract surgery. On the table, it appeared that she already had a continuous curvilinear capsulorrhexis (CCC)  performed in her right eye (Figure 1). This was not observed pre-operatively. Medical notes were rechecked to confirm it was a virgin eye. Surgery was recommenced. CCC (white arrowed) was completed to show the ‘double-ring’ (Figure 2) followed by the disappearance of the ‘double-ring’ sign with the removal of nucleus and soft lens matter, with only the actual CCC remaining (Figure 3) and insertion of intraocular lens (Figure 4). The lens nucleus-cortex interface may, very rarely, mimic the presence of a CCC in a virgin eye. Should the surgeon encounter such unique presentation, medical notes should be double-checked, and if possible directly with the patient, before recommencing surgery. Pre- and peri-operative planning such as the use of intracameral dye e.g. trypan blue  may facilitate the surgeon in visualizing the anterior capsule and confirm with confidence that prior surgery or CCC was certainly not performed.
Keywords: Vitrectomy; Curvilinear capsulorrhexis. Declaration of Interests Both authors have no conflicts of interest to disclose.
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