{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:30:39Z","timestamp":1790793039356,"version":"4.1.0"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:p>A mature, hypermature, or white cataract needs posterior segment evaluation before surgery for prognostification. Ultrasonography is the preferred method for this. White cataract or intumescent cataract risks intraoperative capsulorhexis running out leading to devastating complications due to high intralenticular pressure. Altghough sligh-lamp examination before surgery can gives clue regarding fluid pockets under anterior capsule in these types of cataract, fluid in posterior compartment of lens can be detected by ultrasonography. The author here described a new sign, the double peak sign which can predict the high intra-lenticular pressure especially in posterior compartment of the lens. So if it detected before surgery, all precautions can be taken during surgery to prevent complications. The A-scan overlay on the B-scan in ultrasonography can detect the hypoechoic area corresponding to the lequified cortex in between solid lens nucleus and posterior capsule, so giving rise to the double peak sign which is described here as an innovation.<\/jats:p>","DOI":"10.4103\/ijo.ijo_2418_23","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T05:10:57Z","timestamp":1719897057000},"page":"S712-S714","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Double peak sign on ultrasonography: A new prognostic marker before surgery for white cataract"],"prefix":"10.4103","volume":"72","author":[{"given":"Bhagabat","family":"Nayak","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C S","family":"Lalitha","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruttendu","family":"Moharana","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijnya B","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, AIIMS, Bhubaneswar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"R1-20260507","first-page":"2017","article-title":"Simple way to optimise ultrasonographic visualisation of the retinal periphery and anterior segment structures","author":"Pujari","year":"2017","journal-title":"BMJ Case Rep"},{"key":"R2-20260507","first-page":"2018","article-title":"Ultrasonographic assessment of the lens","author":"Bergaal","year":"2018","journal-title":"BMJ Case Rep"},{"key":"R3-20260507","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1016\/S0161-6420(99)90502-X","article-title":"Ultrasonographic classification and phacoemulsification of white senile cataracts","volume":"106","author":"Brazitikos","year":"1999","journal-title":"Ophthalmology"},{"key":"R4-20260507","doi-asserted-by":"crossref","first-page":"1819","DOI":"10.1016\/S0886-3350(01)01316-5","article-title":"Trypan blue as an adjunct for safe phacoemulsification in eyes with white cataract","volume":"28","author":"Jacob","year":"2002","journal-title":"J Cataract Refract Surg"},{"key":"R5-20260507","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1016\/S0886-3350(00)00525-3","article-title":"Phacoemulsification in eyes with white cataract","volume":"26","author":"Chakrabarti","year":"2000","journal-title":"J Cataract Refract Surg"},{"key":"R6-20260507","doi-asserted-by":"crossref","first-page":"1304","DOI":"10.4103\/ijo.IJO_51_18","article-title":"A multipronged approach to prevent Argentinian flag sign in intumescent cataracts","volume":"66","author":"Dhingra","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"R7-20260507","doi-asserted-by":"crossref","first-page":"4043","DOI":"10.4103\/ijo.IJO_1631_22","article-title":"Vacuum rhexis - A novel capsulorhexis technique for white cataracts","volume":"70","author":"Mahajan","year":"2022","journal-title":"Indian J Ophthalmol"},{"key":"R8-20260507","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1016\/S0886-3350(13)80739-0","article-title":"Two-stage capsulorhexis for endocapsular phacoemulsification","volume":"16","author":"Gimbel","year":"1990","journal-title":"J Cataract Refract Surg"},{"key":"R9-20260507","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.2147\/OPTH.S138676","article-title":"Phaco capsulotomy a technique to prevent the argentinian flag sign","volume":"11","author":"Teng","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"R10-20260507","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.4103\/ijo.IJO_1903_20","article-title":"Achieving successful capsulorhexis in intumescent white mature cataracts to prevent Argentinian flag sign - A new multifaceted approach to meet the challenge","volume":"69","author":"Balyan","year":"2021","journal-title":"Indian J Ophthalmol"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2418_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T16:25:12Z","timestamp":1786724712000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2418_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,5]]},"references-count":10,"journal-issue":{"issue":"Suppl 4","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2418_23","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,5]]},"assertion":[{"value":"2023-09-02","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-01","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}