Search Results (33)

Background and Objectives: Predicting postoperative refractive development after paediatric intraocular lens (IOL) implantation remains challenging due to continued ocular growth and interindividual variability. This scoping review maps current evidence on demographic, biometric, and surgical factors influencing postoperative myopic shift in children undergoing cataract surgery with IOL implantation. Methods and Materials: A systematic literature search was conducted in PubMed and Scopus from the last ten years through October 2025. Eligible studies included children (≤18 years) with congenital or developmental cataract undergoing primary or secondary IOL implantation that reported postoperative refractive change and its predictors. Titles, abstracts, and full texts were screened according to PRISMA-ScR guidelines. Data were charted on study design, age at surgery, follow-up duration, refractive and biometric outcomes, and associated predictors. Results: Twelve studies met the inclusion criteria. Younger age at surgery, shorter preoperative axial length, and unilateral cataract consistently predicted greater postoperative myopic shift. Reported myopic change ranged from approximately −1.8 D after 2 years to −11.6 D after 15 years of follow-up, correlating with the rate of axial elongation. Optical biometry and modern formulas (e.g., Holladay 1) showed lower absolute prediction error than manual A-scan or SRK-II calculations. Postoperative complications, especially glaucoma and visual axis opacification, were associated with greater refractive change. Conclusions: Postoperative myopic shift is a predictable, age-dependent feature of paediatric pseudophakia driven primarily by ocular growth dynamics. Standardised biometry, age-stratified refractive targeting, and integration of longitudinal growth models into IOL calculation algorithms may improve refractive predictability and visual outcomes in children. Full article

Cataracts are one of the leading causes of vision loss in dogs, significantly impairing their quality of life and visual behavior. Phacoemulsification, followed by intraocular lens (IOL) implantation, is currently the gold standard for visual rehabilitation. This non-randomized clinical study included 60 dogs (120 eyes)of various breeds, ages, and sizes, diagnosed with cataracts of different etiologies and degrees of evolution (incipient, mature, hypermature, and intumescent). Postoperative visual function was assessed using conventional neuro-ophthalmologic tests (menace response, cotton ball test, maze navigation) and a custom-designed visual scoring scale developed by the authors to objectively quantify functional recovery. The bimanual technique (Phaco 2) showed slightly shorter surgical times than the monomanual approach (Phaco 1), with significant differences during the capsulorhexis (T1) and IOL implantation (T4) phases (p < 0.05). Postoperative inflammation was mild and transient, with no IOL decentration or posterior capsule opacification observed over 60 days. Visual function improved progressively, with 79.2% (95/120 eyes) reaching functional vision by two months and mean recovery exceeding 90%of normal by day 30. Both techniques provided favorable short-term outcomes for canine cataract extraction, with outcomes mainly influenced by cataract type and lens consistency. The proposed visual scoring system represents a preliminary clinical tool that may support standardized evaluation of postoperative vision in dogs. The results highlight the importance of ongoing refinement in surgical training and the standardization of phacoemulsification protocols to improve reproducibility and long-term outcomes in veterinary ophthalmology. Full article

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

Background/Objectives: The Tecnis Eyhance is an enhanced monofocal intraocular lens (IOL) designed to improve intermediate vision without compromising distance clarity or increasing the incidence of photic phenomena. Although short-term results have been encouraging, long-term data remain limited. This study presents the 5-year follow-up of a previously published 6-month clinical evaluation, aiming to assess the stability of visual, optical, and patient-reported outcomes over time. Methods: A single-center retrospective study of 18 patients (36 eyes) undergoing bilateral Tecnis Eyhance IOL implantation was conducted. The same cohort from the original 6-month study was re-evaluated after a mean follow-up of 5 years. Visual acuity (distance, intermediate, near), defocus curves, contrast sensitivity, optical quality, effective lens position (ELP), halo size, and patient-reported measures were assessed. Results: Visual acuity remained stable across all distances, with binocular uncorrected intermediate visual acuity (UIVA) ≤ 0.2 logMAR in all patients. No significant changes were observed in optical quality parameters or contrast sensitivity. ELP remained consistent over time (p = 0.298), and posterior capsule opacification (PCO) requiring Nd:YAG capsulotomy developed in 5% of the eyes. Halo size was mild, and subjective glare perception did not increase. Spectacle independence remained high for distance (100%) and intermediate (more than 75%) tasks. Conclusions: This 5-year follow-up study confirms the long-term stability and effectiveness of the Tecnis Eyhance IOL. These findings support its long-term use as a stable monofocal IOL with enhanced intermediate function. Full article

Purpose: To review the current literature on the combined use of cataract surgery (or lensectomy) and vitrectomy in pediatric patients, with a focus on clinical indications, surgical techniques, outcomes, and complications across various pediatric ocular pathologies. Methods: A narrative review of published studies addressing the use of combined lensectomy and vitrectomy (LV) in pediatric patients was conducted. Conditions discussed include congenital cataracts, ectopia lentis, retinopathy of prematurity (ROP), retinal detachment (RD), and persistent fetal vasculature (PFV). Key surgical considerations, visual and anatomical outcomes, and postoperative complications were examined. Results: The literature search yielded a total of 160 articles, of which 43 met the inclusion criteria and were included in this review. Although lens-sparing vitrectomy (LSV) is preferred in many pediatric cases to preserve accommodation and reduce complications, combined LV is often necessary in advanced or complex diseases. Studies have shown that combined LV can achieve favorable anatomical outcomes, but functional visual recovery remains variable and is affected by factors such as patient age, baseline ocular anatomy, and disease severity. Postoperative complications such as glaucoma, visual axis opacification (VAO), and intraocular lens (IOL) dislocation are more frequent with combined procedures and require long-term follow-up and rehabilitation. Conclusions: Combined cataract surgery (or lensectomy) and vitrectomy may represent a valuable strategy in the management of complex pediatric ocular conditions, particularly when individualized to the clinical context. Tailored surgical approaches are essential to optimize anatomic and functional outcomes. Further prospective studies and harmonized multicenter registries are needed to develop evidence-based principles that can guide individualized surgical decision-making in this unique patient population. Full article

Intraocular lenses (IOLs) play a pivotal role in restoring vision following cataract surgery. The evolution of polymeric biomaterials has been central to addressing challenges such as biocompatibility, optical clarity, mechanical stability, and resistance to opacification. This review explores essential requirements for IOL biomaterials, emphasizing their ability to mitigate complications like posterior capsule opacification (PCO) and dysphotopsias while maintaining long-term durability and visual quality. Traditional polymeric materials, including polymethyl methacrylate (PMMA), silicone, and acrylic polymers, are critically analyzed alongside cutting-edge innovations such as hydrogels, shape memory polymers, and light-adjustable lenses (LALs). Advances in polymer engineering have enabled these materials to achieve enhanced flexibility, transparency, and biocompatibility, driving their adoption in modern IOL design. Functionalization strategies, including surface modifications and drug-eluting designs, highlight advancements in preventing inflammation, infection, and other complications. The incorporation of UV-blocking and blue-light-filtering agents is also examined for their potential in reducing retinal damage. Furthermore, emerging technologies like nanotechnology and smart polymer-based biomaterials offer promising avenues for personalized, biocompatible IOLs with enhanced performance. Clinical outcomes, including visual acuity, contrast sensitivity, and patient satisfaction, are evaluated to provide an understanding of the current advancements and limitations in IOL development. We also discuss the current challenges and future directions, underscoring the need for cost-effective, innovative polymer-based solutions to optimize surgical outcomes and improve patients’ quality of life. Full article

The Lens Dysfunction Syndrome includes two widespread ocular disorders: presbyopia and cataract. Understanding its etiology, onset, progression, impact, prevention, and treatment remains a significant scientific challenge. The lens is a fundamental structure of the ocular dioptric system that allows for focus adjustment or accommodation to view objects at different distances. Its opacification, primarily related to aging, leads to the development of cataracts. Traditionally, lens alterations have been diagnosed using a slit lamp and later with devices based on the Scheimpflug camera. However, both methods have significant limitations. In recent years, optical coherence tomography (OCT) has become a valuable tool for assessing the lens and pseudophakic intraocular lenses (IOLs) in clinical practice, providing a highly detailed non-invasive evaluation of these structures. Its clinical utility has been described in assessing the shape, location or position, and size of the lens, as well as in determining the degree and type of cataract and its various components. Regarding pseudophakic IOLs, OCT allows for the accurate assessment of their position and centering, as well as for detecting possible complications, including the presence of glistening or IOL opacification. Furthermore, OCT enables the evaluation of the posterior capsule and its associated pathologies, including late capsular distension syndrome. This review highlights the key applications of OCT in the assessment of the lens and pseudophakic IOLs. Full article

Objectives: This study aimed to describe the outcomes of a staged procedure combining Descemet membrane endothelial keratoplasty (DMEK) and sutureless scleral fixation (SSF) of a one-piece intraocular lens (IOL) in a case series. Co-performing endothelial keratoplasty (EK) and SSF is associated with intraoperative and postoperative complications such as graft deployment difficulties, air migration, graft detachment, and IOL opacification or tilt, all of which are evaluated in this study. Methods: This is a retrospective observational case series. Clinical data were collected from eight eyes of eight patients who underwent DMEK for endothelial failure and had previously received an SSF with one-piece IOL following complete vitrectomy. During DMEK surgery, an air leak test was conducted to check for air migration into the posterior chamber. If instability was detected, pupilloplasty was performed. Intraoperative and postoperative data, including DMEK graft unfolding time, were collected. Corrected Distance Visual Acuity (CDVA), refraction, endothelial cell density (ECD), central corneal thickness (CCT), intraocular pressure (IOP), and complications were recorded over a 12-month follow-up period. Results: We performed pupilloplasty in four patients (50%). The median CDVA improved from preoperative 0.85 logMAR (range: 0.60 to 1.00) at baseline to 0.18 logMAR (range: 0.10 to 0.70, p = 0.012) at 12 months. The median refraction value changed significantly from −1.00 to −0.50 at 12 months. The median percentage reduction in ECD after 12 months was 33.4% (range 30 to 40). The median baseline CCT was 689 μm (range: 651 to 701) at baseline visit and 541.5 μm (range: 525 to 591, p = 0.008) at 12 months. The median IOP was reduced significantly during follow-up. The median graft unfolding time was 6 min (5 to 9). One patient required rebubbling for partial detachment on postoperative day one. No complications occurred within 12 months. Conclusions: The effective compartmentalization of the anterior and posterior chambers in vitrectomized eyes with an SSF one-piece IOL and pupilloplasty can facilitate critical steps of DMEK surgery in complex eyes. Additionally, the air leak test could prove useful in identifying the need for iris-lens diaphragm reconstruction. Full article

This paper reviews the latest trends and applications of silicone in ophthalmology, especially related to intraocular lenses (IOLs). Silicone, or siloxane elastomer, as a synthetic polymer, has excellent biocompatibility, high chemical inertness, and hydrophobicity, enabling wide biomedical applications. The physicochemical properties of silicone are reviewed. A review of methods for mechanical and in vivo characterization of IOLs is presented as a prospective research area, since there are only a few available technologies, even though these properties are vital to ensure medical safety and suitability for clinical use, especially if long-term function is considered. IOLs represent permanent implants to replace the natural lens or for correcting vision, with the first commercial foldable lens made of silicone. Biological aspects of posterior capsular opacification have been reviewed, including the effects of the implanted silicone IOL. However, certain issues with silicone IOLs are still challenging and some conditions can prevent its application in all patients. The latest trends in nanotechnology solutions have been reviewed. Surface modifications of silicone IOLs are an efficient approach to further improve biocompatibility or to enable drug-eluting function. Different surface modifications, including coatings, can provide long-term treatments for various medical conditions or medical diagnoses through the incorporation of sensory functions. It is essential that IOL optical characteristics remain unchanged in case of drug incorporation and the application of nanoparticles can enable it. However, clinical trials related to these advanced technologies are still missing, thus preventing their clinical applications at this moment. Full article

Polymeric Intraocular lenses (IOLs) are vital for restoring vision following cataract surgery and for correcting refractive errors. Despite technological and medical advancements, challenges persist in achieving optimal vision and preventing complications. Surface modifications aim to mitigate the risk of posterior capsule opacification (PCO), while pre-operative measurements aid in selecting suitable IOLs. However, individualized solutions are lacking and there is a clear demand for the development of fully customized IOL surfaces. We employ laser micromachining technology for precise modifications via ablation on PMMA and acrylic IOLs, using femtosecond (fs), nanosecond (ns), and diode continuous wave (CW) lasers, at wavelengths ranging from near-ultraviolet to infrared. Characterization reveals controlled ablation patterning, achieving feature sizes from as small as 400 nm to several micrometers. Regular and confocal micro-Raman spectroscopy revealed alterations of the IOL materials’ structural integrity for some patterning cases, thus affecting the optical properties, while these can be minimized by the proper selection of micromachining conditions. The results suggest the feasibility of accurate IOL patterning, which could offer personalized vision correction solutions, based on relevant corneal wavefront data, thus surpassing standard lenses, marking a significant advancement in cataract surgery outcomes. Full article

The widespread use of hydrophilic intraocular lenses (IOLs) in eye surgery, fabricated by poly-2-(hydroxyethyl methacrylate) (PHEMA), has highlighted their calcification as a serious problem, implying that their surgical explantation is a rather risky process. The field of biomaterials has been developing rapidly in recent years, with research interest turning to the development of novel materials which involve either copolymers of PHEMA or protective functional coatings. Graphene coatings are particularly attractive because of their respective unique properties. In the present work, we present the results of the investigation of the development of graphene coatings on hydrophilic IOLs and their subsequent performance with respect to calcification opacification. Hydrophilic IOLs with a water content of 18% by weight were coated with graphene oxide (GO) by equilibration with GO suspensions in water. The concentrations of the suspensions ranged from 1 × 10⁻⁴ to 20 × 10⁻⁴% w/v. The GO suspensions were equilibrated with the IOLs for 5 days at a constant temperature, 37 °C, and rotated in 30 mL tubes end over end. This treatment resulted in the formation of a uniform coating of GO on the IOLs verified by scanning electron microscopy (SEM) and other physicochemical methods. The contact angle of the GO-coated IOLs decreased significantly in comparison with the uncoated IOLs. The GO-coated IOLs exhibited a higher tendency to calcify in supersaturated solutions simulating aqueous humor (SAH). The growth rate of hydroxyapatite (Ca₅(PO₄)₃OH, HAP) on GO-coated IOLs was higher in comparison with the respective untreated IOLs. The conversion of the GO coating via a reduction with phenyl hydrazine resulted in the formation of a reduced-graphene (rGO) surface film, as identified by Raman and XPS spectroscopy. The rGO film was hydrophobic (contact angle 100°) and did not calcify in supersaturated calcium phosphate solutions. Full article

Background and Objectives: Posterior capsular opacification (PCO) is the most common long-term complication of successful cataract surgery and can cause visual impairment. We aimed to investigate the effects of intraocular lens (IOL) characteristics on PCO by comparing the incidence of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy for different types of intraocular lenses. Materials and Methods: A retrospective analysis was performed on 2866 eyes that underwent cataract surgery between January 2010 and December 2017, with at least 5 years of follow-up. The IOLs used for surgery were the hydrophobic lenses SN60WF (Alcon, Fort Worth, TX, USA), ZCB00 (Johnson & Johnson Vision, Santa Ana, CA, USA), and MX60 (Bausch & Lomb, Rochester, NY, USA), and the hydrophilic lens MI60 (Bausch & Lomb, Rochester, NY, USA). We analyzed the incidence of Nd:YAG laser capsulotomy according to the type of IOL used. Results: The incidence of Nd:YAG laser capsulotomy was significantly higher with MI60 lenses (31.70%, 175/552 eyes) compared to SN60WF (7.90%, 113/1431 eyes), ZCB00 (10.06%, 64/636 eyes), and MX60 (10.57%, 13/123 eyes; p < 0.001) lenses. The incidence of Nd:YAG laser capsulotomy was significantly lower with the hydrophobic IOLs (8.68%, 190/2190 eyes) than with the hydrophilic IOL (31.70%, 175/552 eyes; p < 0.001). Over time, the rate of increase in the cumulative number of Nd:YAG laser capsulotomy cases was the highest with MI60. The cumulative rate of Nd:YAG laser capsulotomy during the first 3 years was 4.90% with SN60WF (70/1431 eyes), 6.76% with ZCB00 (43/636 eyes), 8.94% with MX60 (11/123 eyes), and 26.10% with MI60 (144/552 eyes) lenses. Conclusions: The incidence of PCO is influenced by the material of the IOLs. The hydrophilic IOL was associated with a higher rate of Nd:YAG laser capsulotomy than the hydrophobic IOLs, with a shorter time to Nd:YAG laser capsulotomy. Full article

In this retrospective case series, we investigated factors associated with posterior capsule aperture (PCA) reclosure following neodymium-yttrium aluminum garnet (Nd:YAG) laser posterior capsulotomy. The study encompassed patients who underwent cataract surgery with intraocular lens (IOL) implantation or a combined vitrectomy, cataract surgery, and IOL implantation between 2009 and 2022. PCA reclosure was observed in 22 eyes of 17 patients: 45% (10 eyes) underwent the triple procedure, and 55% (12 eyes) received cataract surgery with IOL implantation. In our clinic, 14% of patients were given IOLs with a 4% water content, while 73% (13 eyes) of those experiencing PCA reclosure had IOLs with a 4% water content. The mean interval between Nd:YAG capsulotomies was notably shorter than that between the initial cataract surgery and the first Nd:YAG laser capsulotomy. We also identified five stages of PCA reclosure progression. In conclusion, IOL water content may be linked to PCA reclosure, and the time to recurrence is shorter with each successive reclosure. Further research is needed to verify these findings and uncover additional contributing factors. Full article

Aim: To determine the clinical risk factors that may increase the occurrence of intraocular lens (IOL) calcification in patients who had undergone pars plana vitrectomy (PPV). Methods: The medical records of 14 patients who underwent IOL explantation due to clinically significant IOL opacification after PPV were reviewed. The date of primary cataract surgery, technique and implanted IOL characteristics; the time, cause and technique of PPV; tamponade used; additional surgeries; the time of IOL calcification and explantation; and IOL explantation technique were investigated. Results: PPV had been performed as a combined procedure with cataract surgery in eight eyes and solely in six pseudophakic eyes. The IOL material was hydrophilic in six eyes, hydrophilic with a hydrophobic surface in seven eyes and undetermined in one eye. The endotamponades used during primary PPV were C2F6 in eight eyes, C3F8 in one eye, air in two eyes and silicone oil in three eyes. Two of three eyes underwent subsequent silicone oil removal and gas tamponade exchange. Gas in the anterior chamber was detected in six eyes after PPV or silicone oil removal. The mean interval between PPV and IOL opacification was 20.5 ± 18.6 months. The mean BCVA in logMAR was 0.43 ± 0.42 after PPV, which significantly decreased to 0.67 ± 0.68 before IOL explantation for IOL opacification (p = 0.007) and increased to 0.48 ± 0.59 after the IOL exchange (p = 0.015). Conclusions: PPV with endotamponades in pseudophakic eyes, particularly gas, seems to increase the risk for secondary IOL calcification, especially in hydrophilic IOLs. IOL exchange seems to solve this problem when clinically significant vision loss occurs. Full article

We evaluated the influence of intraocular lens (IOL) opacification on the optical performance of explanted hydrophilic acrylic IOLs. We performed a laboratory analysis of 32 Lentis LS-502-1 (Oculentis GmbH, Berlin, Germany) IOLs, explanted due to opacification, in comparison with six clear unused samples of the same IOL model. Using an optical bench setup, we obtained modulation transfer function (MTF), Strehl ratio, two-dimensional MTF, and United States Air Force (USAF) chart images. In addition, we assessed light transmission through the IOLs. The MTF values of opacified IOLs at 3-mm aperture were similar to those of clear lenses, with the median (interquartile range) values of 0.74 (0.01) vs. 0.76 (0.03) at the spatial frequency of 50 line pairs per millimeter in clear and opacified IOLs, respectively. The Strehl ratio of opacified lenses was not lower than that of clear lenses. The USAF-chart analysis showed a considerable reduction in brightness in opacified IOLs. The median (interquartile range) relative light transmission of opacified IOLs in comparison to clear lenses was 55.6% (20.8%) at the aperture size of 3 mm. In conclusion, the explanted opacified IOLs had comparable MTF values to those of clear lenses but significantly reduced light transmission. Full article