After ocular trauma, primary implantation of a posterior chamber lens is recommended, provided intraocular inflammation and hemorrhage are minimal and the view of anterior segment structures is good. An ACIOL or fixated posterior chamber lens may be necessary if there is inadequate capsular support for a PCIOL. In rare situations, the surgeon may decide against placing an IOL primarily and instead insert an IOL as a secondary procedure after sufficient evaluation of the anterior segment and anterior angle anatomy. Even less commonly, the eye may be left aphakic and managed with a contact lens. Scarring from a corneal laceration changes the contour of the cornea, and inaccurate keratometry and biometry measurements can result in erroneous IOL power selection, increasing the risk of postoperative anisometropia. A rigid contact lens may be required to mask irregular astigmatism from a corneal scar.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.