White ring sign for uneventful lenticule separation in small-incision lenticule extraction

Abstract

We describe the white ring sign, which differentiates the posterior and anterior lenticular planes in small-incision lenticule extraction. The sign identifies the plane of dissection by the anteroposterior relationship between the dissecting instrument and the circular white light reflected from the lenticular side cut. Differentiating the planes enables the surgeon to dissect the anterior plane before the posterior plane, which facilitates smooth lenticule extraction and prevents complications such as cap tears, partial lenticule dissection, and a torn lenticule. FINANCIAL DISCLOSURE: None of the authors has a financial or proprietary interest in any material or method mentioned.