When dealing with a traumatic cataract, the extent of tissue damage is not always fully understood until the surgery begins. In the case shown here, we can tell that the lens equator is partially visible which indicates loss of zonular support in that quadrant. We can also tell that the anterior lens capsule is fibrosed and wrinkled and that will make the capsulohexis more challenging. What would your approach be in this case? The patient is young, in his 30s, and the other eye is emmetropic and normal. Which type of IOL (and what post-op refractive target) would you choose for this surgery? How will you complete the capsulorhexis? And if the capsule runs out, will it still be possible to place a capsular tension ring (CTR)?
