Table 6.

Intraoperative signs to prevent and identify cap lenticular adhesions

Intraoperative sign	Description	Application
Meniscus sign	Meniscus-shaped gap between the inner ring (diameter of lenticule cut) and the lenticule edge created by slightly pushing the lenticule edge away from the surgeon during creation of the posterior lamellar channel	Meniscus sign clearly visible during posterior plane dissection but not during anterior plane dissection Relation of frilled lenticule edge with surgical instruments acts as a guide to identify the correct plane of dissection
Shimmer sign	Bright reflex observed around the dissecting instrument	Reflex is not visible during dissection of anterior plane and helps to identify the correct plane of dissection
White ring sign	Light reflex from the lenticular side cut, which may be better observed using oblique external illumination in darker irides	Position of the white ring relative to the instrument is useful in identifying the dissection plane, as the white ring is posterior to the instrument during anterior plane dissection and anterior to the instrument during posterior plane dissection