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Intraocular Lenses for Cataract Surgery: Clinical Advances and Perspectives
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Intraocular Lenses for Cataract Surgery: Clinical Advances and Perspectives

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: 20 February 2026 | Viewed by 3097

Special Issue Editor

Dr. Choul Yong Park

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Guest Editor
Department of Ophthalmology, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
Interests: cataract surgery; intraocular lens; presbyopia; astigmatism; complication; multifocal; visual acuity; femtosecond; diffractive; refractive; surgical technique

Special Issue Information

Dear Colleagues,

Cataract surgery is a rapidly increasing field in ophthalmology closely linked to the aging global population. Not only has the number of surgical cases increased, but there have also been many technological advancements. The procedure has evolved from extracapsular cataract extraction to phacoemulsification using ultrasound. Technological advancements in ultrasound cataract surgery machines have made it safer and more effective to remove the lens. Additionally, femtosecond laser technology has been introduced to cataract surgery, allowing for the preoperative creation of corneal incisions, anterior capsulotomy, and lens softening, making the surgery even safer. Intraocular lenses (IOLs) have also evolved from monofocal lenses to widely used multifocal and enhanced depth of focus lenses. Due to these technological advancements, cataract surgery is sometimes used as a substitute for presbyopia surgery in some regions, leading to a trend of younger patients undergoing the procedure. In this Special Issue, we are seeking the submission of papers that present the latest advancements in cataract surgery, the optical fundamentals of widely used intraocular lenses (IOLs), and the actual optical comparative evaluations of various premium IOLs available in clinical practice. Additionally, we welcome studies on the complications of IOLs and their treatments, the optimization of IOL calculation formulas for accurate IOL selection, and the most up-to-date trends, current status, and future directions of cataract surgery.

Dr. Choul Yong Park
Guest Editor

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Keywords

  • cataract surgery
  • intraocular lens
  • IOL formula
  • optic
  • complication
  • presbyopia
  • refractive

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Published Papers (4 papers)

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Research

19 pages, 3310 KB  
Article
Distribution and Demographic Correlates of Ocular Wavefront Aberrations in a Korean Population
by Ji Young Seo, Noh Eun Kwon, Jong Hwa Jun and Seung Pil Bang
J. Clin. Med. 2025, 14(19), 6981; https://doi.org/10.3390/jcm14196981 - 2 Oct 2025
Viewed by 454
Abstract
Background/Objectives: Ocular wavefront aberrations are clinically relevant for optimizing vision correction and predicting surgical outcomes. This study aimed to establish normative reference ranges for a Korean population by quantifying wavefront aberrations using a Hartmann–Shack wavefront sensor and Zernike coefficients, and to assess correlations [...] Read more.
Background/Objectives: Ocular wavefront aberrations are clinically relevant for optimizing vision correction and predicting surgical outcomes. This study aimed to establish normative reference ranges for a Korean population by quantifying wavefront aberrations using a Hartmann–Shack wavefront sensor and Zernike coefficients, and to assess correlations with age, sex, and spherical equivalent (SE). Methods: Wavefront aberrations were measured in 98 Koreans (196 eyes) using a Hartmann–Shack aberrometer without cycloplegia. Five repeated measurements per eye at a 6 mm pupil size were averaged. Parameters included Zernike coefficients (Z3–Z20), higher-order aberration (HOA) root mean square (RMS, Z6–Z20), and total RMS (Z3–Z20). Associations with age, sex, and SE were assessed using univariable and multivariable linear mixed-effects models. Second-order polynomial regression assessed nonlinear relationships. Interocular symmetry was evaluated using mirror-symmetry-adjusted Spearman’s correlation and intraclass correlation coefficients (ICCs). Results: Vertical coma (Z7, 0.208 ± 0.174 μm) and spherical aberration (Z12, 0.200 ± 0.161 μm) were the largest contributors to HOA RMS. Mean HOA RMS and total RMS were 0.51 ± 0.21 μm and 3.03 ± 2.51 μm, respectively. HOA RMS increased with age (β = 0.003 μm/year, p = 0.010), whereas total RMS decreased with SE (β = −0.678 μm/D, p < 0.001). Most Zernike coefficients showed positive interocular correlations, with ICCs of 0.75 for total RMS and 0.64 for HOA RMS. Conclusions: In normal Korean eyes, HOAs increased with age and exhibited significant interocular symmetry. Vertical coma and spherical aberration were predominant components. While the pattern was similar to that in Western populations, the absolute values were greater. These normative values may aid future wavefront-guided refractive surgery and presbyopia correction procedures. Full article
(This article belongs to the Special Issue Intraocular Lenses for Cataract Surgery: Clinical Advances and Perspectives)
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7 pages, 334 KB  
Communication
Analyzing the Relationship Between IOL Fixation and PCO Prevention
by David Beckers, Florian Kretz, Jodhbir Mehta and Lena Beckers
J. Clin. Med. 2025, 14(19), 6947; https://doi.org/10.3390/jcm14196947 - 30 Sep 2025
Viewed by 299
Abstract
Background: Posterior capsular opacification (PCO) remains the most common long-term complication following cataract surgery. This correspondence investigates whether intraocular lens (IOL) fixation type influences PCO risk by comparing Nd:YAG capsulotomy rates between capsulotomy-fixated (FEMTIS) and conventional in-the-bag IOLs with similar material and [...] Read more.
Background: Posterior capsular opacification (PCO) remains the most common long-term complication following cataract surgery. This correspondence investigates whether intraocular lens (IOL) fixation type influences PCO risk by comparing Nd:YAG capsulotomy rates between capsulotomy-fixated (FEMTIS) and conventional in-the-bag IOLs with similar material and edge profiles. Methods: A systematic review was conducted. Eligible studies reporting quantitative YAG rates at ≥3 months of follow-up were included. Results: FEMTIS IOLs demonstrated lower capsulotomy rates (3.1% at 12 months) compared to in-the-bag LENTIS lenses (4.7% at 12 months), despite identical optic designs and identical material. Conclusions: This suggests that capsulotomy fixation may promote closer capsule–optic contact and reduce the potential space for lens epithelial cell migration. While data are limited by study heterogeneity and follow-up duration, early evidence supports anterior fixation as a potential strategy to reduce PCO risk and improve long-term capsular clarity. Further prospective studies are warranted. Limitations include heterogeneous study designs, relatively short follow-up, and reliance on Nd:YAG capsulotomy as the sole endpoint. Full article
(This article belongs to the Special Issue Intraocular Lenses for Cataract Surgery: Clinical Advances and Perspectives)
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10 pages, 2878 KB  
Article
Groove Loss Time: A Novel Wound Leakage Test for Sutureless Clear Corneal Cataract Wound Incision
by Sunjin Hwang, Moonsu Kim, Jooyoung Yoon, Eun Hee Hong, Yong Un Shin and Min Ho Kang
J. Clin. Med. 2025, 14(12), 4091; https://doi.org/10.3390/jcm14124091 - 10 Jun 2025
Viewed by 649
Abstract
Background: This study introduces a novel quantitative method—groove loss time (GLT)—to objectively assess wound leakage following cataract surgery. Methods: In this prospective, single-center study, 70 eyes of 70 patients undergoing cataract surgery via CCI were enrolled. Wound sealing was evaluated by measuring the [...] Read more.
Background: This study introduces a novel quantitative method—groove loss time (GLT)—to objectively assess wound leakage following cataract surgery. Methods: In this prospective, single-center study, 70 eyes of 70 patients undergoing cataract surgery via CCI were enrolled. Wound sealing was evaluated by measuring the GLT, defined as the duration the stromal groove remains visible after corneal hydration. GLT was categorized into five grades: ‘water-tight’ (>10 s), ‘excellent’ (>5 s), ‘good’ (3–5 s), ‘bad’ (1–2 s), and ‘poor’ (<1 s). Intraocular pressure (IOP) was recorded at four time points: preoperatively, immediately post-surgery, 3–4 h postoperatively, and on postoperative day one. In select cases, anterior segment optical coherence tomography (AS-OCT) was used to confirm wound architecture. Results: All patients demonstrated a GLT longer than 5 s, corresponding to water-tight or excellent wound sealing. Mean IOP values were 16.08 ± 3.61 mmHg preoperatively, 29.48 ± 11.13 mmHg immediately post-surgery, 16.38 ± 5.45 mmHg at 3–4 h, and 16.65 ± 4.36 mmHg on the day after surgery. No cases of postoperative endophthalmitis, anterior chamber loss, or hypotony were observed. Conclusions: The GLT method provides a simple, objective, and effective tool for evaluating wound integrity in CCIs, ensuring optimal sealing and enhancing postoperative safety. Full article
(This article belongs to the Special Issue Intraocular Lenses for Cataract Surgery: Clinical Advances and Perspectives)
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12 pages, 241 KB  
Article
Iris-Claw Intraocular Lens Implantation in Pediatric Population: Indications, Outcomes, and a Comparison with Adult Population
by Rami Al-Dwairi, Hisham M. Jammal, Mohammad Al Qudah, Hamad Alazmi, Saad Almutairi and Abdelwahab Aleshawi
J. Clin. Med. 2025, 14(4), 1135; https://doi.org/10.3390/jcm14041135 - 10 Feb 2025
Viewed by 1233
Abstract
Objective: The utilization of iris-claw intraocular lens (IOL) in adult cases of capsular insufficiency has been investigated. However, the use of iris-claw IOL in the pediatric population is still under investigation. In this study, we evaluated the overall practice of iris-claw IOL [...] Read more.
Objective: The utilization of iris-claw intraocular lens (IOL) in adult cases of capsular insufficiency has been investigated. However, the use of iris-claw IOL in the pediatric population is still under investigation. In this study, we evaluated the overall practice of iris-claw IOL implantation in pediatrics and compared the visual outcomes and postoperative complication rates between children and adults. Methods: Retrospectively, we examined the practice, indications, and outcomes of pediatric patients who underwent iris-claw “Artisan®” intraocular lens implantation (IOL). All patients who underwent iris-claw IOL implantation for any causative indications were enrolled in the study. The outcome was compared by visual acuity and postoperative complications. Furthermore, the outcomes in pediatrics were compared to another adult group. Results: In this study, 41 eyes of 34 pediatric patients were included with a mean age of 11.1 years and a mean follow-up period of 24.5 months. Trauma is the most common indication for iris-claw IOL in pediatrics, followed by ectopia lentis and by congenital cataract. Iris-claw IOL was implanted anteriorly in 70.7% of pediatrics. Patients with retropupillary position achieved better visual outcome. Anterior iris-claw IOL had higher intraocular pressure readings and more decentration and disenclavation. In comparison with the adult group consisting of 130 eyes, pediatric iris-claw implantation was associated with more decentration and disenclavation, while adult practice was associated with more macular edema. Conclusions: Iris-claw IOL offers a relatively safe method for optical rehabilitation in pediatric patients where the capsular support is inadequate. Retropupillary implantation may achieve better visual outcome with less frequency of glaucoma and corneal endothelial loss. Full article
(This article belongs to the Special Issue Intraocular Lenses for Cataract Surgery: Clinical Advances and Perspectives)
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