Current Opinion In Ophthalmology[JOURNAL]
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200 papers
The role of diet and nutrition in glaucoma.
Younis DA, Richter GM
Curr Opin Ophthalmol · 2026 Mar · PMID 41431228 · Publisher ↗
PURPOSE OF REVIEW: This review aims to explore the connection between diet and nutritional intake with optic nerve health for patients with glaucoma. RECENT FINDINGS: Using the AAO Grading Criteria to determine level of...
PURPOSE OF REVIEW: This review aims to explore the connection between diet and nutritional intake with optic nerve health for patients with glaucoma. RECENT FINDINGS: Using the AAO Grading Criteria to determine level of evidence, Level 1 and Level 2 studies reviewed here examine associations between nutritional intake and glaucoma. Increasing consumption of dietary nitrates and retinols, incorporating the Mediterranean diet, and reducing intake of ultra-processed foods to lower glaucoma risk are supported by Level 1 evidence. Level 2 evidence suggests that dietary niacin, antioxidants, fruits, and vegetables have potential to improve optic nerve health and are associated with reduced glaucoma risk. Evidence from both Level 1 and Level 2 studies suggest that combining multiple beneficial dietary components may produce more meaningful effects to reduce glaucoma risk than single dietary factors alone. SUMMARY: Although some studies highlight the protective role of single dietary components against glaucoma, adopting a combination of beneficial dietary habits appears to be more effective as an adjunctive treatment to enhance optic nerve health and lower glaucoma risk.
Cataract surgery in patients with diabetes mellitus: preoperative, intraoperative, and postoperative considerations.
Garcia-Cabrera CR, Afshari NA
Curr Opin Ophthalmol · 2026 Jan · PMID 41343850 · Publisher ↗
PURPOSE OF REVIEW: Diabetes mellitus may influence different stages of cataract surgery, from preoperative evaluation to postoperative recovery. With the rapid increase in the global prevalence of diabetes, understanding...
PURPOSE OF REVIEW: Diabetes mellitus may influence different stages of cataract surgery, from preoperative evaluation to postoperative recovery. With the rapid increase in the global prevalence of diabetes, understanding evidence-based strategies for optimizing surgical outcomes is critical. RECENT FINDINGS: Studies have found that fixed glycated hemoglobin (HbA1c) thresholds alone should not be used to determine the timing of surgery. Instead, a macula-first approach, integrating retinal co-management and optical coherence tomography (OCT) for diabetic patients, allows for tailored decision-making. Key advancements include ocular surface optimization to enhance biometry accuracy, proactive perioperative anti-inflammatory regimens combining NSAIDs and corticosteroids, and selective use of intravitreal anti-VEGF or corticosteroid therapy for diabetic macular edema (DME). Lens choice should refrain from multifocal optics in eyes with diabetic macular diseases. Emerging equity frameworks underscore the need to replace systemic cut-offs with risk-based protocols to enhance access and outcomes. SUMMARY: Modern cataract surgery in patients with diabetes requires an individualized retina-integrated approach that emphasizes inflammation control and macular preservation. Embedding equity-driven, OCT-based pathways ensures that surgical excellence extends to populations most affected by diabetes-related vision loss.
Beyond the phaco tip: is artificial intelligence the next frontier in cataract surgery?
Garcia-Cabrera CR, Afshari NA
Curr Opin Ophthalmol · 2026 Jan · PMID 41343849 · Publisher ↗
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Glaucoma management reconsidered: insights from LiGHT, ZAP, TAGS, PTVT, and EAGLE.
Taylor K, Mosenia A, Bowden EC
Curr Opin Ophthalmol · 2026 Mar · PMID 41330523 · Publisher ↗
PURPOSE OF REVIEW: Several high-quality prospective clinical trials have emerged in recent years that have provided evidence to support changes in management of glaucoma. This article reviews results from five recent lan...
PURPOSE OF REVIEW: Several high-quality prospective clinical trials have emerged in recent years that have provided evidence to support changes in management of glaucoma. This article reviews results from five recent landmark studies and discusses how they may impact clinical practice. RECENT FINDINGS: Five multicenter trials - LiGHT, ZAP, EAGLE, TAGS, and PTVT - have reshaped glaucoma management strategies. LiGHT demonstrated that selective laser therapy is a well tolerated and effective first-line therapy for open-angle glaucoma. ZAP investigated routine use of prophylactic laser peripheral iridotomy, emphasizing the importance of risk stratification in primary angle closure suspects. EAGLE established clear-lens exchange as a viable alternative to conventional treatment in select patients with angle closure anatomy. TAGS showed that primary trabeculectomy provides better intraocular pressure (IOP) control and reduced visual field progression in advanced disease. Finally, PTVT highlighted that both trabeculectomy and tube shunt surgeries remain appropriate initial surgeries, with procedure choice best guided by baseline IOP, risk tolerance, and patient goals. SUMMARY: Improvements in laser and surgical technology, increased understanding of the natural history of glaucoma, and evidence regarding the importance of early intervention in disease have led to fundamental changes in glaucoma practice. The five clinical trials reviewed in this article support these shifts and provide frameworks to guide clinical practice.
Eying up predatory bacteria: living antimicrobials for ocular infections.
Shanks RMQ, Romanowski EG, Patel DR … +1 more , Kadouri DE
Curr Opin Ophthalmol · 2026 May · PMID 41330426 · Full text
PURPOSE OF REVIEW: The growing threat of antibiotic-resistant pathogens, particularly in ocular infections like bacterial keratitis, necessitates alternative therapeutic strategies. This review evaluates the potential th...
PURPOSE OF REVIEW: The growing threat of antibiotic-resistant pathogens, particularly in ocular infections like bacterial keratitis, necessitates alternative therapeutic strategies. This review evaluates the potential therapeutic role of predatory bacteria as novel live antimicrobials, offering a timely exploration of their potential in overcoming resistance mechanisms such as biofilm formation and persister cell development. RECENT FINDINGS: Predatory bacteria, including Bdellovibrio bacterovorus and Micavibrio aerguinosavorus selectively target Gram-negative bacteria, including Pseudomonas aeruginosa , while sparing Gram-positive ocular surface. They exhibit rapid bactericidal activity and efficacy against biofilms, persister cells, and antibiotic-resistant pathogens, but induce little inflammation. Advances in storage and delivery methods, such as lyophilization, cryomicroneedles, and thermoresponsive hydrogels, have potential to increase their therapeutic feasibility. However, in-vivo efficacy remains variable and their narrow spectrum limits effectiveness against Gram-positive pathogens. SUMMARY: Predatory bacteria present a promising alternative to traditional antibiotics in ocular therapeutics, particularly for drug-resistant infections. Integration of predatory bacteria with bacteriophages or conventional antibiotics may further optimize their potential. Continued translational research is essential to address current limitation and to validate their safety and efficacy for human or veterinary applications.
Antifibrotics in glaucoma surgery: current practices and future directions.
Santilli C, Sheheitli H
Curr Opin Ophthalmol · 2026 Mar · PMID 41329942 · Publisher ↗
PURPOSE OF REVIEW: This review aims to cover the current landscape of antifibrotics used in glaucoma surgery and discuss developing antifibrotic agents. This review will inform the reader of new antifibrotic agents in de...
PURPOSE OF REVIEW: This review aims to cover the current landscape of antifibrotics used in glaucoma surgery and discuss developing antifibrotic agents. This review will inform the reader of new antifibrotic agents in development, clinical trials and clinical use that may alter the standard of care in glaucoma surgery in the near future. RECENT FINDINGS: Mitomycin-C (MMC) remains the most commonly used antifibrotic in glaucoma surgery to date with expanding use beyond trabeculectomy into the world of minimally invasive bleb forming surgeries. MMC continues to cause similar side effects due to toxicity which is a main driver of innovation. Newer antifibrotic agents are under investigation at all stages of drug development from bench research to clinical use. Familiar agents such as bevacizumab, sodium hyaluronate, and matrix metalloproteinases have shown noninferior success rates to MMC when used as adjunct agents with filtration surgery. Many other antifibrotics agents are being investigated with mixed results. SUMMARY: While MMC remains the gold standard antifibrotic agent for glaucoma surgery, there are numerous antifibrotic agents in development with safer side effect profiles and similar success rates that may change the surgical practice of glaucoma.
Big data in ophthalmology: comparative databases and research applications.
Ayoubi M, Sayed MS, Khodeiry MM … +2 more , Elhusseiny AM, Lee RK
Curr Opin Ophthalmol · 2026 Mar · PMID 41329931 · Publisher ↗
PURPOSE OF REVIEW: This review aims to highlight the expanding role of big data in ophthalmology, provide a comparison of the most prominent databases, and their use in glaucoma-specific research. Understanding the stren...
PURPOSE OF REVIEW: This review aims to highlight the expanding role of big data in ophthalmology, provide a comparison of the most prominent databases, and their use in glaucoma-specific research. Understanding the strengths and limitations of each database allows researchers to tailor their research questions appropriately. RECENT FINDINGS: Several large-scale databases have emerged in ophthalmology research. Some databases offer detailed ocular exam findings and imaging, supporting artificial intelligence-driven diagnostics and treatment evaluation. Others are broader in scope, providing real-world population data to study trends and outcomes. Some databases even integrate genomic and systemic data, enabling novel explorations of disease risk and health disparities. Collectively, big data has enabled large-scale studies on a wide range of topics, advancing the field of ophthalmology in every aspect. SUMMARY: Big data platforms are transforming ophthalmology research, from uncovering systemic-ocular relationships to enabling artificial intelligence applications. Researchers can select platforms based on the availability of imaging, systemic data, or genomic information to better address specific research questions. Doing so can enhance precision medicine, address care disparities, and drive innovation in disease pathophysiology discovery, detection, and management.
Middle segment surgery: indications, techniques, and future directions.
Hannush SB, Chayet A, Ifantides C
Curr Opin Ophthalmol · 2026 Jan · PMID 41314637 · Publisher ↗
PURPOSE OF REVIEW: Middle segment surgery (MSS) refers to ophthalmic surgical intervention through the pars plana to prevent or manage anterior segment abnormality and surgical challenges/complications. It has gained int...
PURPOSE OF REVIEW: Middle segment surgery (MSS) refers to ophthalmic surgical intervention through the pars plana to prevent or manage anterior segment abnormality and surgical challenges/complications. It has gained interest in recent years due to its expanding indications and utility across ophthalmic subspecialties. Although MSS has been employed for decades, its integration into contemporary ophthalmic surgery requires a multidisciplinary understanding of both anterior and posterior segment diagnostics, treatment options and surgical techniques. RECENT FINDINGS: Although the nomenclature MSS may be relatively new, there is significant evidence in the literature that the intervention of choice to resolve anterior segment, especially lens-related, abnormality and postoperative surgical complications may be best offered not only through the limbus but also through the pars plana. The surgeon may have training in anterior or posterior segment techniques. Cross training may be ideal in this setting. SUMMARY: This article reviews foundational skills necessary for MSS, outlines current clinical indications, and proposes pathways for training, credentialing, and future innovation.
The evolving fate of the corneal endothelium in cataract surgery.
Folk GA, Afshari NA
Curr Opin Ophthalmol · 2026 Jan · PMID 41251071 · Publisher ↗
PURPOSE: Cataract surgery, the most commonly performed ophthalmic procedure, can result in corneal endothelial cell loss (ECL), which can have a lasting impact due to the endothelium's limited regenerative capacity. This...
PURPOSE: Cataract surgery, the most commonly performed ophthalmic procedure, can result in corneal endothelial cell loss (ECL), which can have a lasting impact due to the endothelium's limited regenerative capacity. This review highlights surgical technologies and considerations that can provide protection of the corneal endothelium. RECENT FINDINGS: Endothelial cell density (ECD) at birth is about 3,000-5,000 cells/mm 2 and decreases 0.3-0.6% per year, with the adult eye endothelial cell density being approximately 2000-3000 cells/mm 2 . Most ECL occurs within the first three months after surgery, with attributing factors including shallow anterior chamber depth (ACD), low baseline ECD, and high cumulative dissipated energy (CDE), as well as patient-specific comorbidities. Diabetes has been shown to play a role in corneal endothelium recovery, as central corneal thickness (CCT) was found to be significantly higher in diabetic patients after cataract surgery at one month compared to nondiabetic patients, although not at six months in a meta-analysis. Modern fluidics platforms enhance chamber stability and minimize turbulence, and low-perfusion phacoemulsification has decreased ECL rates in high-risk eyes. Corneal tunnel length has been identified as an intraoperative factor; in eyes with short anterior chamber depth, longer tunnel lengths are associated with greater ECL. Microincision surgery, ultrasound energy modulation, and femtosecond laser use provide additional benefits. Hydrogen-enriched irrigating solutions were found to potentially significantly reduce early ECL, and chondroitin sulfate-hyaluronic acid ophthalmic viscosurgical devices (OVDs) further lowered both cell loss and corneal edema. SUMMARY: Advances in surgical technology, combined with individualized planning based on risk factors and anterior segment anatomy, enable minimization of ECL and optimize visual outcomes.
Impact of insurance status on toric premium intraocular lens selection for patients undergoing cataract surgery with astigmatism.
Ashby CK, Sitto MM, Sant DW … +1 more , Moshirfar M
Curr Opin Ophthalmol · 2026 Jan · PMID 41242759 · Publisher ↗
PURPOSE OF REVIEW: To evaluate the association between insurance status and the selection of toric premium intraocular lenses (IOLs) among patients undergoing cataract surgery with astigmatism. RECENT FINDINGS: In this r...
PURPOSE OF REVIEW: To evaluate the association between insurance status and the selection of toric premium intraocular lenses (IOLs) among patients undergoing cataract surgery with astigmatism. RECENT FINDINGS: In this retrospective study of 4525 patients (7299 eyes), 71.3% of eyes received conventional IOLs, and 28.7% received premium IOLs, of which 34.8% were toric lenses. Logistic regression with adjustment for age, sex, and surgeon was used to assess associations between insurance status and IOL selection. Patients with commercial insurance were significantly more likely to select toric IOLs (14%) than those with Medicare (9.2%, P < 0.001) and Medicare Advantage (7.6%, P < 0.001). Among eyes with moderate-to-severe astigmatism (≥1.5 D), 40.7% were estimated to be eligible for toric correction, yet only 24.5% received a toric IOL. SUMMARY: Insurance status significantly influences toric IOL selection, with lower utilization observed among patients with Medicare and Medicare Advantage. Many patients deemed eligible for toric correction did not receive a toric IOL, suggesting underutilization likely driven by cost and insurance coverage limitations. With astigmatic correction becoming more common in cataract surgery, policy discussions should balance clinical efficacy and affordability of toric IOLs to improve access and visual outcomes.
Toric intraocular lenses: advancements in astigmatism correction.
Wallace RT, Balakrishnan UL, Weikert MP
Curr Opin Ophthalmol · 2026 Jan · PMID 41191961 · Publisher ↗
PURPOSE OF REVIEW: Toric intraocular lenses (IOL) predictably correct corneal astigmatism and are an important part of the cataract and refractive surgeon's toolbox. RECENT FINDINGS: Advances in toric IOL technology, pre...
PURPOSE OF REVIEW: Toric intraocular lenses (IOL) predictably correct corneal astigmatism and are an important part of the cataract and refractive surgeon's toolbox. RECENT FINDINGS: Advances in toric IOL technology, preoperative biometry, IOL power calculations, and IOL alignment have resulted in excellent visual outcomes and achievement of spectacle independence. Despite these advancements, the primary challenges faced in toric IOL use remain choosing the optimal IOL toricity and properly aligning the IOL. SUMMARY: Toric IOL are an effective way to correct corneal astigmatism, and advancements in lens selection and design have improved their functionality for patients. This review summarizes these advances and reports on upcoming technologies.
Manual small incision cataract surgery.
Winterton C, Mai A, Pettey J
Curr Opin Ophthalmol · 2026 Jan · PMID 41175388 · Publisher ↗
PURPOSE OF REVIEW: To provide an updated review of manual small incision cataract surgery (MSICS), including training innovations, advancements in surgical techniques, system-level performance, and equity implications in...
PURPOSE OF REVIEW: To provide an updated review of manual small incision cataract surgery (MSICS), including training innovations, advancements in surgical techniques, system-level performance, and equity implications in global cataract care. RECENT FINDINGS: As global cataract burden continues to rise, MSICS has gained traction as a cost-effective and scalable solution, particularly in low and middle-income countries (LMICs). Simulator-based training and new surgical tools have enhanced early proficiency among trainees. Recent data highlight MSICS as a procedure with comparable complication rates and patient-reported satisfaction to phacoemulsification, assuming proficiency of the surgeon. Key research gaps persist in skill transferability, long-term outcomes, and sex disparities in access. SUMMARY: MSICS remains a pivotal surgical technique in the fight against global cataract blindness. Its affordability and adaptability to resource-limited settings make it a critical part of international efforts to expand cataract surgical coverage and promote equitable eye care delivery.
Cataract surgery in keratoconus: current challenges and future directions.
Sarnicola C, Sarnicola E, Sarnicola V
Curr Opin Ophthalmol · 2026 Jan · PMID 41175387 · Publisher ↗
PURPOSE OF REVIEW: Cataract surgery in keratoconus remains one of the most challenging settings in anterior segment surgery. This review summarizes recent evidence (2020-2025) on intraocular lens (IOL) power calculation,...
PURPOSE OF REVIEW: Cataract surgery in keratoconus remains one of the most challenging settings in anterior segment surgery. This review summarizes recent evidence (2020-2025) on intraocular lens (IOL) power calculation, surgical strategies, and adjunctive treatments, highlighting current limitations and future perspectives. RECENT FINDINGS: Advances in keratoconus-specific formulas such as Barrett True-K and Kane-KC, particularly when posterior corneal curvature is measured, have improved refractive accuracy compared with conventional formulas, though prediction errors remain higher than in normal eyes. Toric IOLs are effective in carefully selected mild-to-moderate cases, with multimeasurement calculators improving astigmatic prediction and a 2025 systematic review confirming safety and stability. Small-aperture optics (IC-8) may increase depth of focus, but keratoconus-specific evidence is limited. Staged approaches, including intracorneal ring segments, cross-linking, and DALK in advanced disease, improve safety and predictability. Emerging technologies such as artificial intelligence-based calculators and premium IOLs show promise but require further validation. SUMMARY: Despite significant progress, outcomes in keratoconus remain less predictable than in normal eyes. Careful patient selection, keratoconus-adjusted formulas, and staged surgical strategies are essential. Future priorities include prospective validation of formulas, integration of artificial intelligence tools, and evaluation of adjustable optics.
Surgical techniques for complicated cataracts: managing dense or white cataracts.
Ahad MA, Almazyad EM
Curr Opin Ophthalmol · 2026 Jan · PMID 41175386 · Publisher ↗
PURPOSE OF REVIEW: To review recent advances in the surgical management of dense white cataracts, focusing on preoperative assessment, biometry, capsulotomy techniques, phacoemulsification systems, and surgical outcomes....
PURPOSE OF REVIEW: To review recent advances in the surgical management of dense white cataracts, focusing on preoperative assessment, biometry, capsulotomy techniques, phacoemulsification systems, and surgical outcomes. RECENT FINDINGS: Swept-source optical coherence tomography (SS-OCT) biometers now achieve nearly universal axial length measurements even in dense lenses, improving refractive predictability. Anterior segment OCT and Scheimpflug imaging facilitate detection of intralenticular fluid pockets and capsular thinning, guiding decompression strategies to prevent anterior capsule tears. Innovations in manual capsulorhexis, preoperative Nd:YAG (neodymium-doped yttrium aluminum garnet) decompression, and device-based techniques (precision pulse capsulotomy and selective laser capsulotomy) have improved reproducibility and reduced Argentinian flag sign incidence. Low-energy femtosecond laser-assisted cataract surgery further enhances endothelial safety in selected cases. In phacoemulsification, newer platforms with advanced fluidics and tips have decreased cumulative energy use, turbulence, and endothelial cell loss. For very dense nuclei, manual small-incision cataract surgery remains a practical alternative with lower endothelial trauma in specific settings. SUMMARY: Advances in ocular imaging, biometry, capsulotomy, and phacoemulsification technology have significantly improved the safety and predictability of dense white cataract surgery. Incorporating these innovations into surgical practice has reduced the incidence of intraoperative complications, including anterior capsular tears, posterior capsule ruptures, and endothelial cell loss, while enhancing refractive outcomes.
Toward autonomous discovery: agentic AI and the future of ophthalmic research.
Soetikno BT, Nielsen CS, Pollreisz A … +1 more , Ting DSW
Curr Opin Ophthalmol · 2026 Jan · PMID 41175385 · Publisher ↗
PURPOSE OF REVIEW: Rapid advances in large language models (LLMs) have led to the emergence of agentic artificial intelligence (AI) systems capable of autonomously performing complex scientific tasks. This review examine...
PURPOSE OF REVIEW: Rapid advances in large language models (LLMs) have led to the emergence of agentic artificial intelligence (AI) systems capable of autonomously performing complex scientific tasks. This review examines recent developments in agentic AI, highlighting their transformative potential for ophthalmology research and clinical practice, and discusses associated ethical considerations. RECENT FINDINGS: Recent studies demonstrate that agentic AI systems can autonomously execute tasks traditionally performed by human researchers, including peer review, hypothesis generation, systematic reviews, and experimental design. Notable examples include AI-generated manuscripts accepted through peer review, automated systematic reviews outperforming human accuracy and efficiency, and performing complex biomedical analyses across diverse domains. Although direct ophthalmology-specific applications remain nascent, the field's data-rich nature positions it ideally for adopting agentic AI in several areas such as automated chart review, health economics modeling, and enhanced image analysis. SUMMARY: Agentic AI represents a paradigm shift in scientific research, offering significant opportunities to enhance productivity, rigor, and innovation in ophthalmology. However, integration into clinical and research workflows necessitates careful consideration of ethical issues, including authorship attribution, data privacy, bias mitigation, and accountability. Clear governance frameworks, rigorous validation standards, and interdisciplinary training will be essential to responsibly harness agentic AI in ophthalmology.
Novel artificial intelligence applications for pediatric retina.
Antonio-Aguirre B, Gadiraju A, Ownagh V … +1 more , Vajzovic L
Curr Opin Ophthalmol · 2025 Sep · PMID 40965415 · Publisher ↗
PURPOSE OF REVIEW: This review examines the emerging role of artificial intelligence (AI) in the detection and management of pediatric retinal diseases, with a focus on systems that achieve expert-level performance in cl...
PURPOSE OF REVIEW: This review examines the emerging role of artificial intelligence (AI) in the detection and management of pediatric retinal diseases, with a focus on systems that achieve expert-level performance in classifying fundus abnormalities. We highlight models developed for clinical application as assistive or autonomous tools with the potential to enhance early identification and referral, streamline care delivery, and improve access to care. RECENT FINDINGS: AI systems, have shown high diagnostic accuracy in identifying retinal pathology associated with retinopathy of prematurity, pediatric myopia, diabetic retinopathy, and retinoblastoma. Many of these systems have potential utility in real-world screening, supplementing clinical decision-making, and guiding early intervention. In addition, autonomous AI systems can increase access in low-resource, remote settings and areas where access to pediatric ophthalmologists is limited. Ongoing advances include integration with nonmydriatic fundus photography, smartphone-based imaging, and image-free diagnostic modalities, further expanding reach and applicability. SUMMARY: AI holds transformative promise for pediatric retina care by providing scalable, accurate, and accessible screening solutions. These systems have demonstrated to enhance clinical expertise, minimize interobserver variability, facilitate timely referrals and support decision-making. As integration of algorithms into clinical and community settings is established, AI is poised to become an essential component of pediatric ophthalmology, improving early detection and reducing the global burden of preventable childhood blindness.
Accelerating insight: the role of artificial intelligence in health economic analysis for ophthalmology.
Nielsen CS, Soetikno BT, Pollreisz A … +1 more , Ting DSW
Curr Opin Ophthalmol · 2025 Sep · PMID 40938134 · Publisher ↗
PURPOSE OF REVIEW: Traditional health economic analysis is essential for guiding healthcare decision-making but is hindered by slow, resource-intensive processes. This review examines how recent advancements in artificia...
PURPOSE OF REVIEW: Traditional health economic analysis is essential for guiding healthcare decision-making but is hindered by slow, resource-intensive processes. This review examines how recent advancements in artificial intelligence can automate and accelerate the core components of health economic analysis, from evidence generation to economic modeling and regulatory submissions, and explores the implications of this transformation for ophthalmology. RECENT FINDINGS: Recent proof-of-concept studies demonstrate that artificial intelligence can automate systematic literature reviews with high accuracy, significantly reducing screening times while matching or exceeding the sensitivity of human reviewers. In economic modeling, artificial intelligence systems can now autonomously write and adapt complex simulation code from textual descriptions, replicating the results of published models with near-perfect fidelity. Furthermore, to ensure rigor, new reporting guidelines like ELEVATE-GenAI are emerging alongside proactive regulatory position statements from health technology assessment agencies like NICE. While direct applications in ophthalmology remain in their early stages, these combined developments signal a transformative potential to accelerate the cost-effectiveness assessment of emerging sight-saving technologies. SUMMARY: Artificial intelligence-driven automation represents a paradigm shift in health economic analysis, enabling evaluations that once took months to be completed in a fraction of the time. This capability is particularly critical for ophthalmology's rapidly evolving technological landscape, enabling dynamic assessment of innovations from artificial intelligence-powered diagnostics and robotic surgical systems to novel gene therapies and advanced pharmaceuticals. Although challenges remain regarding analytical validity, bias amplification, and regulatory acceptance, the integration of artificial intelligence promises to accelerate evidence-based adoption of sight-saving technologies through responsive, context-specific economic insights.
Presbyopia-correcting intraocular lenses in eyes with corneal conditions: an update.
McNeely RN, Moore JE, Mehta JS … +1 more , Ting DSJ
Curr Opin Ophthalmol · 2026 Jan · PMID 40920465 · Publisher ↗
PURPOSE OF REVIEW: Modern presbyopia-correcting intraocular lenses (IOLs) offer a potential solution to address the rising postoperative demand and expectations for spectacle independence following cataract surgery. Howe...
PURPOSE OF REVIEW: Modern presbyopia-correcting intraocular lenses (IOLs) offer a potential solution to address the rising postoperative demand and expectations for spectacle independence following cataract surgery. However, IOL calculation and selection becomes more complex when presented with previous corneal refractive surgery (CRS) or co-existing corneal conditions. This review explores the use of presbyopia-correcting IOLs in eyes with co-existing corneal conditions or surgically altered corneas. RECENT FINDINGS: Careful consideration and selection is required in patients with co-existing corneal conditions who desire spectacle independence. Presbyopia-correcting IOLs have been shown to be safe and provide good uncorrected vision in eyes with previous CRS. Modern biometry formulas have improved predictability in eyes with previous CRS, though evidence related to presbyopia-correcting IOLs is limited. Pinhole IOLs may be suitable for eyes with irregular/aberrated corneas. Further evidence regarding presbyopia-correcting IOLs is required in eyes with dry eye disease, keratoconus, and corneal graft. Knowledge of the range of available IOLs are key to optimizing visual quality and achieving spectacle independence. SUMMARY: Patients with prior CRS or co-existing corneal disease(s) present unique challenges when considering presbyopia-correcting IOLs. While promising options are available, successful outcomes depend on careful patient selection, thorough corneal assessment, and realistic management of patient expectations.
The utility of artificial intelligence in ophthalmic clinical trials.
Nath S, Rahimy E, Kras A … +1 more , Korot E
Curr Opin Ophthalmol · 2025 Sep · PMID 40910945 · Publisher ↗
PURPOSE OF REVIEW: The current article provides an overview of the utility of artificial intelligence approaches to aid in the design, recruitment, execution, and dissemination of ophthalmic clinical trials. RECENT FINDI...
PURPOSE OF REVIEW: The current article provides an overview of the utility of artificial intelligence approaches to aid in the design, recruitment, execution, and dissemination of ophthalmic clinical trials. RECENT FINDINGS: Within the last decade, artificial intelligence has heralded a new age for ophthalmology, with novel applications habitually appearing within the literature. Though clinical trials are considered the gold standard for driving evidence-based practice, remarkably few studies have examined the potential for machine learning to augment the clinical trial pipeline. Clinical trials within ophthalmology often do not reach planned endpoints due to insufficient enrolment, cost overruns, and can lack reliability from unblinded outcome assessors. Ones that do, frequently take longer to enroll patients than intended. Artificial intelligence-based approaches have recently been shown to be effective in identifying eligible clinical trial participants using both imaging and text data. SUMMARY: Given the key role of clinical trials in the advancement of ophthalmic clinical practice, trialists should consider the potential for artificial intelligence-powered tools to enhance the design, recruitment, and delivery of future studies.
Artificial intelligence oculomics for systemic health and longevity medicine: 2025 and beyond.
Yao J, Hong ASY, Fukutsu K … +1 more , Ting DSW
Curr Opin Ophthalmol · 2025 Sep · PMID 40910901 · Publisher ↗
PURPOSE OF REVIEW: With the rise of 'oculomics' and the application of advanced artificial intelligence techniques in healthy ageing, retinal imaging, the only way we can directly visualize the microvascular circulation,...
PURPOSE OF REVIEW: With the rise of 'oculomics' and the application of advanced artificial intelligence techniques in healthy ageing, retinal imaging, the only way we can directly visualize the microvascular circulation, is expanding beyond ophthalmology into broader systemic health monitoring. The purpose of this review is to summarize recent advances in this rapidly evolving field and assess the opportunities, challenges, and future directions of the use of oculomics in translating into real-world clinical use. RECENT FINDINGS: Retinal imaging modalities, such as color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA), and wide-field imaging, are increasingly integrated with deep learning algorithms to detect, predict, and manage a broad spectrum of systemic diseases, including cardiovascular, cerebrovascular, renal, metabolic, and neurodegenerative disorders, as well as less commonly studied conditions. While research in more established areas is beginning to address clinical translation and implementation, significant challenges remain before these technologies can be reliably adopted in long-term, real-world healthcare settings. SUMMARY: Artificial intelligence applied to retinal imaging has matured from proof-of-concept classifiers to externally validated, occasionally regulated tools that noninvasively profile systemic conditions. Multiplexed foundation models and multimodal transformers herald a shift toward holistic 'oculomics' platforms, yet prospective multicenter trials, equitable performance auditing, and health-economic evaluations are essential before widescale clinical adoption.
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