Traumatic cataract in a young patient with myopia.

A 36-year-old man was referred to our clinic because of traumatic cataract in his right eye, which had developed after being hit in the eye with a badminton shuttle as a child. He noticed that his vision in his right eye was gradually becoming worse. His refraction, corrected with spectacles, was -4.25 -2.00 × 115 in his right eye and -5.50 -1.50 × 57 in his left eye, with a corrected distance visual acuity of 20/32 and 20/20, respectively. Because of allergies, the patient never tolerated contact lens wear for more than 2 hours. On a slitlamp examination, we confirmed anterior subcapsular star-like cataract without any signs of zonulolysis. Optical biometry showed an axial length of 25.73 mm and 26.66 mm and an anterior chamber depth of 3.70 mm and 3.78 mm in the right and left eyes. Keratometric astigmatism measured by optical biometry was 1.56 diopters (D) at 30 degrees and 1.12 D at 138 degrees for the right and left eyes, and Scheimpflug tomography showed 1.1 D of regular astigmatism at 33 degrees in the right eye, and 0.9 D of regular astigmatism at 130 degrees in the left eye. The patient is a professional photographer and asked for a treatment that would still allow him to be able to perform his job: he wants to read all the buttons on the camera up close and focus on the scenery in the distance. What is your advice on this challenging case?