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Rationale:

Traumatic cataract must not be mindlessly treated as an age-related one. The surgeon must decide preoperatively how to remove the lens without causing additional damage to the already injured eye.

The most important two questions to decide are:

1) should vitrectomy instrumentation be utilized and

2) should the lens capsules be removed?

If the wrong technique is chosen (no vitrectomy instrumentation when a vitreous prolapse into the anterior chamber or into the lens itself), the result is traction on the anterior vitreous with consequent traction on the retinal periphery. If a retinal detachment occurs in the early postinjury period, the surgeon who never looked at the posterior pole will conveniently blame this on the injury, rather than himself. If the lens capsules are retained in the hope of serving as the ideal location for IOL implantation (“in-the-bag at all cost”) and PVR later develops or the capsules simply shrink, leading to phthisis, the surgeon again will blame the body’s natural reaction, rather than himself – for a problem that could have been prevented by not leaving the capsules behind; there are other methods of IOL implantation. (And in any case, this is of secondary importance in an eye with a potentially blinding injury.) Summary: Those two points will be illustrated by videofilms.