Ocular trauma involving anterior segment, especially lens and iris, can seriously affect vision, which cause traumatic cataract and traumatic iris defects. It is a terrific challenge for ophthalmologists to deal with blindness due to traumatic cataract with surgical management. The success of surgery is based in adequate communication and personalized analysis. In this case, the patient with traumatic cataract and traumatic iris defects was unable to work and experienced a tough life with financial burden. It is a heavy burden and harmful for society as well. Thus in this situation, patients should not be abandoned and it is necessary to perform surgeries to reconstruct the anterior segment of the patient’s eye.
The surgery included two major parts. The first part is removing opacified lens and implantation of IOL. For traumatic cataract patients, the choice of intraocular lens is very important. After accurate preoperative measurements, we chose HOYA IOL as the IOL we implanted in the patient’s eye. The HOYA IOL had three-piece form with good elasticity, which could be implanted conveniently, and firmly. Besides, the thin haptics of this IOL effectively avoided repeated friction of the patient’s damaged iris.
The second part is separating posterior synechia and closing the breaches of the iris. Iris directly determines the amount of light that enters into the eye. Deficient iris can diminish visual acuity because of increased spherical aberration, glare, photophobia, decreased contrast sensitivity, and decrease depth of focus . Small iris defects can be repaired using microtying suture techniques while large defects need to be replaced by implantable iris material. In 2012, Spitzer M, S, et al.  describe a new surgical technique for treating traumatic aniridia with aphakia using a 3-piece acrylic intraocular lens through the haptics to a customized silicone iris prosthesis. In this case, suture of the iris defect effectively improved the visual acuity and photophobia of this patient.
We presented a case of traumatic cataract with iris defects after explosive trauma. We performed a surgery to fully reconstruct the anterior segment of the patient’s left eye and improved the visual acuity and photophobia of this patient. Our case suggested the importance of completely reconstruct anterior segment for patients who have traumatic cataract with traumatic iris defects and its benefits for society.