Open research questions in Intraocular Surgery and Lenses

What the literature leaves open

• Further studies are needed to evaluate the long-term outcomes of the BIL technique. The BIL technique can be compared to other IOL implantation techniques. The technique can be modified and improved for better outcomes.

  Bag-in-the-lens technique · 2026 · DOI

• There is a need for a technique that can prevent PCO and other complications after IOL implantation. The current techniques for IOL implantation have limitations and risks. There is a need for a comprehensive review of the BIL implantation technique.

  Bag-in-the-lens technique · 2026 · DOI

• Pediatric cataract surgery presents unique challenges, particularly regarding visual rehabilitation and the restoration of binocular function. The use of multifocal IOLs in pediatric patients is limited due to concerns regarding optical quality, neuroadaptation, and long-term refractive changes. The potential disadvantages of trifocal optics must be explicitly acknowledged.

  Trifocal Intraocular Lens Implantation in Pediatric Traumatic Cataract: Functional Recovery Including Stereopsis · 2026 · DOI

• Ocular surface problems are prevalent after cataract surgery. Preservative-containing eye drops can disrupt the lipid layer of the tear film. There is a need for effective treatment protocols to promote and maintain ocular surface integrity.

  Evaluation of The Ocular Surface with and Without Preservatives in the Treatment of Patients Undergoing Cataract Surgery · 2026 · DOI

• Pediatric cataract surgery has unique challenges due to the smaller eye and higher anterior capsule elasticity. The need for minimally invasive methods for congenital cataract surgery. The risk of postoperative complications such as elevated IOP and astigmatism.

  Surgical outcomes of 27-gauge sutureless versus 23-gauge sutured techniques in congenital cataract surgery: a comparative study · 2026 · DOI

• Further studies are needed to evaluate the long-term outcomes of ISBCS in pediatric patients. Studies are needed to compare the cost-effectiveness of ISBCS and DSBCS in different healthcare settings.

  Immediate versus delayed sequential bilateral cataract surgery for paediatric congenital cataracts in a teaching institute: A comparative study · 2026 · DOI

• There is a lack of studies comparing ISBCS and DSBCS in pediatric patients with bilateral congenital cataracts. There is a need to evaluate the safety and effectiveness of ISBCS in pediatric patients.

  Immediate versus delayed sequential bilateral cataract surgery for paediatric congenital cataracts in a teaching institute: A comparative study · 2026 · DOI

• Detecting mild zonular weakness using conventional slit-lamp examination. Anticipating the need for capsular support or alternative IOL fixation.

  Evaluation of lens parameters using anterior segment optical coherence tomography for zonular weakness risk in cataract surgery · 2026 · DOI

• Studies on zonular weakness remain limited. Conventional slit-lamp examination has low sensitivity for detecting mild zonular weakness.

  Evaluation of lens parameters using anterior segment optical coherence tomography for zonular weakness risk in cataract surgery · 2026 · DOI

• The high precision required in ICL implantation. The need to evaluate the benefits and limitations of 3D systems in ophthalmic surgery. The potential for complications with 3D systems.

  Comparison of three-dimensional surgical system versus binocular microscope for implantable Collamer lens implantation: a randomized clinical trial · 2026 · DOI

• Future studies should investigate the cost-effectiveness of 3D systems in ophthalmic surgery. Future studies should compare the outcomes of 3D systems in different types of ophthalmic surgeries. Future studies should evaluate the long-term outcomes of 3D systems in ICL implantation.

  Comparison of three-dimensional surgical system versus binocular microscope for implantable Collamer lens implantation: a randomized clinical trial · 2026 · DOI

• The risk of delayed diagnosis, - Patient misinformation, - The need for clear communication about the lack of supporting evidence

  Iridology: Biological plausibility, clinical evidence, and implications for ophthalmic practice · 2026 · DOI

• Ultrasonography localized the lens but could not assess capsular integrity or angle anatomy.

  Diagnostic Challenge of Mixed Lens-Induced Glaucoma After Chronic Traumatic Posterior Lens Dislocation: A Case Report · 2026 · DOI

• The direct cause of cataract formation is not known. The lens changes can be brought about by a variety of local and systemic disorders and toxic insults.

  Lens Morphology, Aging, and Cataract · 1983 · DOI

• Currently, there is insufficient evidence to conclude that penetrating FSLACS-AK pro- vides a significantly greater astigmatic correction than intrastromal FSLAK.

  Femtosecond laser assisted phacoemulsification plus IOL implant: toric IOL vs. astigmatic keratotomy · 2026 · DOI

• Predicting CE occurrence in patients with preoperatively normal endothelia remains challenging. Traditional methods like logistic regression have limitations in integrating multidimensional clinical data and optimizing prediction accuracy.

  Machine learning for risk stratification of postoperative corneal edema in East Asian cataract patients: a model for precision ophthalmology · 2026 · DOI

• There is a need for effective medications to prevent IOP spikes after Nd:YAG laser capsulotomy. The efficacy of dexmedetomidine in preventing IOP rise after Nd:YAG laser treatment is unknown.

  The Prophylactic Effect of Dexmedetomidine 0.008% Versus Brimonidine 0.2% on <scp>IOP</scp> Elevation After Nd: <scp>YAG</scp> Laser Capsulotomy · 2026 · DOI

• The gap in recognizing repeated optical biometry failure as a diagnostic clue for late in-the-bag intraocular lens dislocation. The need for timely tertiary referral and individualized surgical planning for patients with late in-the-bag intraocular lens dislocation.

  Repeated Optical Biometry Failure as an Underrecognized Marker of Late In-the-Bag Intraocular Lens Decentration in Axial Myopia: A Case Report · 2026 · DOI

• Further studies with larger cohorts and long-term follow-up are required to better define the role of trifocal IOLs in pediatric patients. Investigation into the potential disadvantages of trifocal optics, including reduced contrast sensitivity and dysphotopsia, is needed.

  Trifocal Intraocular Lens Implantation in Pediatric Traumatic Cataract: Functional Recovery Including Stereopsis · 2026 · DOI

• The study aims to determine the accuracy of biometric calculations in patients after cataract surgery at Waled Regional General Hospital, Cirebon in 2022, which has not been previously studied.

  The Accuracy of Biometrics on Patients After Cataract Surgery in The Ophtalmic Ward of Waled Regional Public Hospital in Year 2022 · 2026 · DOI

• There is a need for accurate visualization of the anterior chamber angle during minimally invasive glaucoma surgery. The choice of gonioscopic lens is important for optimal visualization.

  Intraoperative Gonioscopy – A Necessity for Minimally Invasive Glaucoma Surgery · 2026 · DOI

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  Intraoperative Gonioscopy – A Necessity for Minimally Invasive Glaucoma Surgery · 2026 · DOI

• There is a lack of understanding about the effects of preservative-containing and preservative-free eye drops on ocular surface health. There is a need for studies that investigate the impact of preservative-containing eye drops on tear film stability.

  Evaluation of The Ocular Surface with and Without Preservatives in the Treatment of Patients Undergoing Cataract Surgery · 2026 · DOI

• Further studies are needed to evaluate the long-term outcomes of posterior chamber phakic implantable collamer lens implantation. Comparative studies between different ICL models are necessary to inform clinicians' decisions. Research on the cost-effectiveness of ICL implantation is needed.

  Five-year outcomes of posterior chamber phakic implantable collamer lens implantation in high myopia, keratoconus, and post-keratoplasty eyes · 2026 · DOI

• There is a need to evaluate the long-term outcomes of posterior chamber phakic implantable collamer lens implantation. The comparison of V4c ICLs to previously published iris-fixated phakic intraocular lenses (IF pIOLs) is necessary. The safety and efficacy of the V4c ICL model for high myopia, keratoconus, and post-keratoplasty eyes need to be assessed.

  Five-year outcomes of posterior chamber phakic implantable collamer lens implantation in high myopia, keratoconus, and post-keratoplasty eyes · 2026 · DOI

Most-cited papers in Intraocular Surgery and Lenses

• The consequences of waiting for cataract surgery: a systematic review · Canadian Medical Association Journal · 2007 · 124 citations
• Magnifying Loupes in Modern Dental Practice: An Update · Dental Update · 2010 · 39 citations
• Cataract surgery—indications, techniques, and intraocular lens selection · Deutsches Ärzteblatt international · 2023 · 35 citations
• The retrobulbar block: A review of techniques used and reported complications · Equine Veterinary Education · 2020 · 12 citations
• Refractive aim and visual outcome after phacoemulsification: A 2-year review from a Tertiary Private Eye Hospital in Sub-Saharan Africa · Nigerian Journal of Clinical Practice · 2016 · 10 citations
• The Exactness of Intraocular Lens Power Calculation Formulas for Short Eyes and Correlation Between Method Accuracy and Eyeball Axial Length · Czech and Slovak Ophthalmology · 2022 · 9 citations
• Presbyopia Management with Diffractive Phakic Posterior Chamber IOL · Czech and Slovak Ophthalmology · 2020 · 7 citations
• Long-term mortality after retinal artery occlusion – a single centre study · Annals of Agricultural and Environmental Medicine · 2023 · 7 citations
• RESTORING SIGHT: EXPLORING CATARACTS AS THE LEADING TREATABLE CAUSE OF BLINDNESS: A NARRATIVE REVIEW · TURKISH MEDICAL STUDENT JOURNAL · 2024 · 7 citations
• Intraoral Local Anesthesia and Ocular Complications · World Journal of Dentistry · 2013 · 6 citations

Most recent work

• Intraocular lens tilt and decentration in congenital ectopia lentis: baseline characteristics and first-year report · International Journal of Ophthalmology · 2026
• Femtosecond laser assisted phacoemulsification plus IOL implant: toric IOL vs. astigmatic keratotomy · Frontiers in Medicine · 2026
• Sulcus fixation of a standard capsular tension ring in cataract surgery with capsular instability · International Journal of Ophthalmology · 2026
• Evaluating Student Attitude towards Careers in Ophthalmology as a Medical Option Southern India · Journal of chemical health risks · 2026
• Active fluidics at lower intraocular pressure reduces intraoperative discomfort during phacoemulsification: a propensity score-matched cohort study · Frontiers in Medicine · 2026
• Long-term outcomes of congenital cataract surgery in eyes with microcornea operated within the first year of life · Scientific Reports · 2026
• “Just the way we always did it”: ophthalmologist perspectives on changing routine anesthesia care for cataract surgery in the United States · Perioperative Medicine · 2026
• Machine learning for risk stratification of postoperative corneal edema in East Asian cataract patients: a model for precision ophthalmology · Graefe's Archive for Clinical and Experimental Ophthalmology · 2026
• Endothelial Cell Loss After Phacoemulsification in a Romanian Cohort: Early Outcomes and Associated Risk Factors · Diagnostics · 2026
• Bag-in-the-lens technique · Frontiers in Ophthalmology · 2026

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