PURPOSE: Establish a classification system of lens capsule defects after ocular trauma and intraocular surgery by providing data of clinical descriptions and intraocular lens (IOL) implantations, based on clinical features of the lens capsule during and/or after surgery reviewed in 156 eyes.

METHODS: A retrospective study of 128 patients (156 eyes) with crystalline lens capsule injury after ocular trauma and intraocular surgery that were divided into 2 groups: Lens surgery group and combined surgery group.  Capsule defects were defined and classified according to the location, size, shape, tension of the capsule and its effect on posterior chamber IOL implantation.

RESULTS: Lens capsule defects were classified into four types: Type I – integrated capsular; Type II – incomplete capsule, but the remains has enough area and tension to support two IOL haptics; Type III – incomplete capsule, able to support only one IOL haptic and the other haptic needs a suture; Type IV – non-capsule, IOL both haptics need suture fixation. Type I and Type II were subdivided into three subtypes. Type III was subdivided into two subtypes. The shape of capsule defects included fissure-liked, round, irregular, and fan-liked. Type II was the most common among the two groups in our study. In the lens surgery group, there were 3 eyes of Type I, 34 eyes of Type II, and 5 eyes of Type III; In the combined surgery group, there were 21 eyes of Type I, 62 eyes of Type II, 17 eyes of Type III, and 14 eyes of Type IV. No significant difference of the distribution of lens capsule defects was found between the two surgery groups.

CONCLUSION: Systematic classification of lens capsule defects is feasible and favorable for uniform clinical description, clinical research, and IOL implantation.