Current Opinion In Ophthalmology[JOURNAL]
Sun
200 papers
Laser vision correction (LASIK, PRK, SMILE) with simultaneous accelerated corneal crosslinking.
Lim L
Curr Opin Ophthalmol · 2026 Jun · PMID 42348672 · Publisher ↗
PURPOSE: Laser in-situ keratomileusis (LASIK Xtra), photorefractive keratectomy (PRK Xtra) and small-incision lenticule extraction (SMILE Xtra) are procedures currently performed worldwide. This review analyses recent li...
PURPOSE: Laser in-situ keratomileusis (LASIK Xtra), photorefractive keratectomy (PRK Xtra) and small-incision lenticule extraction (SMILE Xtra) are procedures currently performed worldwide. This review analyses recent literature (2020-2025) on corneal refractive surgery combined with simultaneous corneal crosslinking (CXL) (LASIK Xtra, PRK Xtra and SMILE Xtra) to determine its overall safety and efficacy. METHODS: A comprehensive literature search of various electronic databases (PubMed, PubMed Central and MEDLINE) was performed up to 30 December 2025 and articles in English pertaining to clinical outcomes of LASIK Xtra, PRK Xtra and SMILE Xtra published between 2020 to 2025 were included. Overall results including efficacy and safety were evaluated. Efficacy and safety indices are calculated where possible. RESULTS: Ten relevant studies were found for LASIK Xtra, 3 for PRK Xtra and 8 for SMILE Xtra. Current studies show that refractive surgery and simultaneous CXL produces comparable results in terms of refractive and keratometric stability to refractive surgery alone. Studies that performed LASIK Xtra, PRK Xtra and SMILE Xtra procedures in susceptible eyes showed no cases of postoperative keratectasia. Studies evaluating corneal biomechanical properties showed that LASIK Xtra, PRK Xtra and SMILE Xtra conferred some biomechanical advantages. CONCLUSIONS: Simultaneous accelerated cross-linking and laser vision correction is both safe and effective for the treatment of myopia. No cases of postoperative keratectasia was reported in studies where these procedures were performed in susceptible eyes, indicating a certain biomechanical advantage conferred.
Traumatic macular hole: observe, operate, or other options.
Muste JC, DeSimone JD, Yonekawa Y
Curr Opin Ophthalmol · 2026 Jun · PMID 42299813 · Publisher ↗
PURPOSE OF REVIEW: Traumatic macular holes (TMH) represent a distinct subset of macular holes arising from ocular trauma. This review examines controversies in TMH management: whether and when to operate, how to interpre...
PURPOSE OF REVIEW: Traumatic macular holes (TMH) represent a distinct subset of macular holes arising from ocular trauma. This review examines controversies in TMH management: whether and when to operate, how to interpret OCT biomarkers as prognostic guides, special considerations in the pediatric population, and the role of emerging surgical and pharmacologic alternatives. RECENT FINDINGS: Minimum hole diameter and the presence of intraretinal cysts appears to reliably stratify eyes by likelihood of spontaneous closure. Pediatric TMH generally demonstrates high spontaneous closure rates. Vitrectomy with ILM peeling achieves high anatomical closure rates; while earlier surgery has been associated with better visual outcomes in observational data, this association is likely confounded by the tendency to observe longer in eyes with more extensive comorbidities and poorer baseline prognosis. Topical treatment is an option, and adjuvant maneuvers and plugging material can be considered during vitrectomy for refractory or TMHs at high risk for nonclosure. SUMMARY: The association between earlier surgery and better visual outcomes in the literature requires careful interpretation due to case-mix confounding. A systematic, optical coherence tomography-guided approach integrating hole characteristics, patient age, and associated ocular injuries allows individualized management of TMH. Continued refinement of surgical techniques is promising for large and refractory holes.
The evolving role of artificial intelligence in ophthalmology: basic science, translation, and clinical integration.
Miller MN, Hsu D, Tailor PD … +1 more , Starr MR
Curr Opin Ophthalmol · 2026 May · PMID 42224074 · Publisher ↗
PURPOSE OF REVIEW: Ophthalmology has emerged as the proving ground for medical artificial intelligence (AI) because of its imaging-centric workflows, standardized data acquisition, and well defined clinical endpoints. Re...
PURPOSE OF REVIEW: Ophthalmology has emerged as the proving ground for medical artificial intelligence (AI) because of its imaging-centric workflows, standardized data acquisition, and well defined clinical endpoints. Recently, the field has started transitioning from narrowly trained, task-specific algorithms toward multimodal models that are trained on large datasets and can be adapted to many tasks. These models may integrate information from images, text, and clinical data and are increasingly trialed in real-world settings. This review examines recent advances and ongoing controversies in the use of AI as a basic science, translational, and clinical research tool in ophthalmology. RECENT FINDINGS: Recent literature highlights the growing role of self-supervised and foundation models for scalable phenotyping, biomarker discovery, and cross-task generalization, particularly in retinal imaging and optical coherence tomography (OCT). In parallel, large-scale clinical deployments, including cloud-based OCT platforms and autonomous diabetic retinopathy screening, demonstrate clinical impact while revealing persistent challenges related to workflow integration and patient generalizability. Regulatory and ethics-focused studies underscore increasing attention to validation rigor, bias, and postdeployment monitoring, exposing heterogeneity in research standards and physician practices. SUMMARY: Ophthalmic AI is maturing toward real-world clinical implementation. Future progress will depend less on performance gains alone and more on clinical alignment, rigorous validation, equity-aware evaluation, and postdeployment surveillance, alongside continued investment in basic science to advance disease understanding and inform robust, generalizable model development.
Editorial: reducing risk for refractive surgery.
Donaldson KE, Lee JK
Curr Opin Ophthalmol · 2026 Jul · PMID 42206716 · Publisher ↗
Abstract loading — click title to view on PubMed.
Updates on Refractive Surgery: Benefits, Risks, and Costs of Modern Treatment Options.
Bandaru D, Zhou IS, Zhu D
Curr Opin Ophthalmol · 2026 May · PMID 42177634 · Publisher ↗
PURPOSE OF REVIEW: To provide updates on modern refractive procedures including benefits, risks, costs, and clinical considerations. RECENT FINDINGS: Refractive surgery demonstrates excellent safety and efficacy in appro...
PURPOSE OF REVIEW: To provide updates on modern refractive procedures including benefits, risks, costs, and clinical considerations. RECENT FINDINGS: Refractive surgery demonstrates excellent safety and efficacy in appropriately selected patients. Recent studies demonstrate differences between cornea- and lens-based procedures in postoperative visual recovery, refractive predictability, ocular surface impact, side effect profiles, enhancement strategies, and cost-efficiency. These distinctions highlight the importance of careful patient selection and screening across the wide range of refractive treatment options to maximize visual function and satisfaction. SUMMARY: Modern refractive surgery includes effective treatment options without a one-size-fits-all approach. Understanding the nuances between procedures is critical for clinical decision-making and matching the "best" treatment option to each patient.
Corneal Allogeneic Intrastromal Ring Segments for keratoconus - recent evidence and the move to customized and custom shaped CAIRS.
Jacob S, Awwad ST, Agarwal A
Curr Opin Ophthalmol · 2026 Jul · PMID 42142377 · Publisher ↗
PURPOSE OF REVIEW: This review focuses on the use in patients with keratoconus, of corneal allogeneic intrastromal ring segments (CAIRS) as well as customized and custom shaped CAIRS for corneal reshaping, stabilization...
PURPOSE OF REVIEW: This review focuses on the use in patients with keratoconus, of corneal allogeneic intrastromal ring segments (CAIRS) as well as customized and custom shaped CAIRS for corneal reshaping, stabilization and individualized, tissue-based corneal contouring, while delaying or avoiding keratoplasty. RECENT FINDINGS: CAIRS is being widely used in advanced cases of keratoconus, as biological replacement for synthetic intra-corneal ring segments and to prevent the need for keratoplasty. It is also being adopted in early disease in combination with corneal cross-linking. Various techniques and modifications are described as well as its use in different situations. Femtosecond and double bladed trephined CAIRS are discussed, including recent unpublished data demonstrating comparable dimensional accuracy with both. Double bladed trephines may also offer potential for greater segment thickness and customization. SUMMARY: CAIRS is evolving into a customizable corneal contouring approach that may complement and potentially reduce reliance on, existing treatment modalities. When combined with corneal cross-linking, it offers both biomechanical stabilization and visual rehabilitation. Future advances are likely to center on data-driven personalization tailored to each patient's corneal phenotype and visual needs, an approach that becomes increasingly important as CAIRS use expands in keratoconus.
Optimizing outcomes in keratolimbal allograft for limbal stem cell deficiency.
Aruljyothi L, Anitha V, Likosky K … +1 more , Nallasamy N
Curr Opin Ophthalmol · 2026 Jul · PMID 42142022 · Publisher ↗
PURPOSE OF REVIEW: The present review will focus on recent advancements affecting outcomes in keratolimbal allograft (KLAL). RECENT FINDINGS: Recent advancements involve methodologies for donor selection, eye bank prepar...
PURPOSE OF REVIEW: The present review will focus on recent advancements affecting outcomes in keratolimbal allograft (KLAL). RECENT FINDINGS: Recent advancements involve methodologies for donor selection, eye bank preparation of KLAL tissue, risk stratification, and immunosuppression to prevent both early and late immunologic rejection. SUMMARY: Keratolimbal allograft (KLAL) remains an essential technique for addressing severe limbal stem cell deficiency in patients without access to a suitable living donor eye (whether autologous or allogeneic). While outcomes of KLAL have traditionally lagged behind those of living-related limbal allografts, recent advancement in KLAL techniques may reduce this gap.
Surgical technology update for ophthalmic surgery: heads-up display, artificial intelligence, instrumentation, and robotics.
Chawla K, Tailor PD, Sridhar J
Curr Opin Ophthalmol · 2026 May · PMID 42105745 · Publisher ↗
PURPOSE OF REVIEW: Rapid advances in surgical visualization, microsurgical instrumentation, artificial intelligence (AI), and robotic assistance are reshaping ophthalmic surgery. This review evaluates current clinical an...
PURPOSE OF REVIEW: Rapid advances in surgical visualization, microsurgical instrumentation, artificial intelligence (AI), and robotic assistance are reshaping ophthalmic surgery. This review evaluates current clinical and experimental evidence to determine how these technologies influence surgical efficiency, precision, safety, and patient outcomes. RECENT FINDINGS: Three-dimensional (3D) heads-up display systems (HUDS) subjectively improve surgeon ergonomics and permit lower illumination levels while maintaining complication rates equivalent to conventional microscopy. Advances in surgical instrumentation, including smaller-gauge vitrectomy systems, high-speed cutters, preloaded intraocular lens (IOL) delivery systems, and device-based glaucoma implants demonstrate gains in operative efficiency without compromising anatomic success. AI-based systems enable automated surgical phase recognition, real-time instrument tracking, and outcome prediction with high accuracy. Robotic platforms offer the promise of sub-millimeter instrument stabilization and feasibility of high-precision maneuvers across ophthalmic subspecialties. SUMMARY: Emerging technologies have enhanced technical performance in ophthalmic surgery. However, most demonstrated benefits concentrate on ergonomics, workflow efficiency, and motion stability, with fewer studies showing consistent improvements in long-term clinical outcomes. Larger multicenter trials are needed to define true clinical value, cost-effectiveness, and optimal clinical integration.
Tranexamic acid in oculofacial plastic surgery: a review of current evidence.
Murdock N, Watson AH
Curr Opin Ophthalmol · 2026 May · PMID 42105737 · Publisher ↗
PURPOSE OF REVIEW: Oculofacial plastic and orbital surgery is performed in an anatomic region where even modest bleeding can result in significant morbidity. Tranexamic acid (TXA) use in the perioperative period has demo...
PURPOSE OF REVIEW: Oculofacial plastic and orbital surgery is performed in an anatomic region where even modest bleeding can result in significant morbidity. Tranexamic acid (TXA) use in the perioperative period has demonstrated safety and efficacy in reduce intraoperative bleeding and postoperative ecchymosis. This review discusses perioperative TXA use and antithrombotic management in oculofacial surgery. RECENT FINDINGS: Prospective and randomized studies in eyelid, periocular, nasolacrimal, and facial aesthetic surgery demonstrate that intravenous, oral, and local TXA reduce postoperative ecchymosis and edema, and in some settings decrease intraoperative blood loss and operative time. Safety data across surgical specialties consistently show no increased risk of thromboembolic complications. However, prospective evidence guiding perioperative continuation vs. cessation of antithrombotic therapy in oculofacial surgery remains limited. SUMMARY: TXA is a safe, cost-effective adjunct that improves postoperative recovery in oculofacial plastic surgery. While current evidence supports its routine use in selected procedures, further research is needed to define its role in orbital surgery and in patients maintained on chronic antithrombotic therapy.
Imaging in anterior segment disorders.
Kapur N, Gour A, Sangwan V
Curr Opin Ophthalmol · 2026 May · PMID 42105377 · Publisher ↗
PURPOSE OF REVIEW: This review highlights the rapid advancements in anterior segment imaging and their relevance in enhancing the diagnosis and management of corneal disorders. RECENT FINDINGS: Innovations in imaging - i...
PURPOSE OF REVIEW: This review highlights the rapid advancements in anterior segment imaging and their relevance in enhancing the diagnosis and management of corneal disorders. RECENT FINDINGS: Innovations in imaging - including anterior segment optical coherence tomography (AS-OCT), Scheimpflug imaging, and in-vivo confocal microscopy (IVCM) - have transformed the evaluation of anterior segment pathology. These modalities enable detailed assessment of corneal morphology, thickness, and cellular integrity across various conditions such as keratitis, peripheral ulcerative keratitis, keratoconus, pellucid marginal degeneration, and Fuchs' endothelial dystrophy. AS-OCT and IVCM are increasingly used to guide treatment decisions and monitor disease progression or surgical outcomes.In refractive surgery and ectatic disorder screening, devices like Pentacam and UBM offer critical preoperative insights. Aberrometry and meibography are key in enhancing postoperative outcomes. Intraoperative OCT (iOCT) improves precision in keratoplasty, while artificial intelligence enhanced imaging platforms offer real-time pathology recognition and risk stratification. The growing use of smartphone adapters and telemedicine platforms further supports remote care and follow-up, particularly in resource-limited settings. SUMMARY: Multimodal imaging has become integral to anterior segment disease management, enabling early diagnosis, refined surgical planning, and improved visual outcomes. Ongoing research into artificial intelligence and integrated imaging systems promises even greater clinical efficiency and diagnostic accuracy in the near future.
Geographic atrophy: From slowing lesions to preserving vision.
Mang K, Eichenbaum D, Vakharia P
Curr Opin Ophthalmol · 2026 May · PMID 42105376 · Publisher ↗
PURPOSE OF REVIEW: Geographic atrophy, the advanced form of dry age-related macular degeneration (AMD), has historically been evaluated using structural endpoints and best-corrected visual acuity (BCVA). This review exam...
PURPOSE OF REVIEW: Geographic atrophy, the advanced form of dry age-related macular degeneration (AMD), has historically been evaluated using structural endpoints and best-corrected visual acuity (BCVA). This review examines the growing rationale for a function-first approach. RECENT FINDINGS: Emerging data demonstrate that functional deficits often decline earlier and more profoundly than BCVA. Recently approved complement inhibitors have shown slowing of geographic atrophy lesion growth but without consistent improvements in traditional visual acuity endpoints. Extension studies and post hoc analyses suggest some functional benefits. Next-generation therapies are increasingly incorporating functional endpoints into trial design. SUMMARY: Structural slowing alone does not fully capture therapeutic value in geographic atrophy. Functional measures provide a more sensitive and patient-centered assessment of disease progression and treatment impact.
Advances in anterior segment imaging.
Henick D, Chow J
Curr Opin Ophthalmol · 2026 Jul · PMID 42101439 · Publisher ↗
PURPOSE OF REVIEW: Ophthalmologists use anterior segment imaging for diagnosis, measurement, monitoring, and treatment of a variety of conditions. Imaging modalities continue to improve in their precision and reliability...
PURPOSE OF REVIEW: Ophthalmologists use anterior segment imaging for diagnosis, measurement, monitoring, and treatment of a variety of conditions. Imaging modalities continue to improve in their precision and reliability, and as such research is needed to discover and demonstrate additional utilities and applications that can further enhance the ophthalmologist's diagnostic toolkit. This review summarizes key research studies over the past 12-18 months and explains how ophthalmologists, ranging from comprehensive to cornea and keratorefractive surgeons, can integrate these imaging techniques into their practice. RECENT FINDINGS: Recent research in anterior segment imaging techniques, particularly optical coherence tomography of the anterior segment, epithelial thickness mapping, and wavefront aberrometry, has demonstrated how these modalities can be integrated to improve diagnostic precision and augment the clinical exam. Increased knowledge about these techniques has allowed ophthalmologists to use imaging to diagnose and monitor conditions of the anterior segment very closely, even in cases with subtle findings that may not be easily seen on slit lamp examination. SUMMARY: Ophthalmologists benefit from advanced imaging technologies that enhance diagnosis and clinical decision-making, and recent research on developments in anterior segment imaging demonstrate how these modalities can be integrated in a wide variety of settings to improve patient care.
Role of microbiome in ocular surface disease: interpreting biology in a low-biomass environment.
Yashar M, Thigale UY, Karakus S
Curr Opin Ophthalmol · 2026 Jul · PMID 42101202 · Publisher ↗
PURPOSE OF REVIEW: Growing use of sequencing technologies has accelerated investigation of the ocular surface microbiome, yet this environment is characterized by extremely low microbial biomass, complicating data interp...
PURPOSE OF REVIEW: Growing use of sequencing technologies has accelerated investigation of the ocular surface microbiome, yet this environment is characterized by extremely low microbial biomass, complicating data interpretation. This review assesses current evidence linking microbial communities to ocular surface disease, discusses methodological and biological factors influencing interpretation of microbiome-disease associations, and proposes a framework in which microbial roles may be considered as drivers, modifiers, or markers. RECENT FINDINGS: Studies across multiple ocular surface diseases report alterations in microbial composition, including reduced α-diversity and shifts in dominant taxa. Genera such as Staphylococcus , Corynebacterium , and Cutibacterium are frequently reported as resident members of the ocular surface microbiome, although their abundance varies across individuals and sampling sites. Across diseases, microbial patterns often overlap and remain inconsistent between studies. Emerging mechanistic evidence has identified specific microbial products, such as lipoteichoic acid, that promote ocular surface inflammation through defined signaling pathways, providing initial support for a potential driver or modifier role. In low-biomass environments such as the ocular surface, contamination, host DNA predominance, and methodological variability can strongly influence detected microbial signals. SUMMARY: Interpretation of ocular surface microbiome data remains inherently challenging in this low-biomass context. However, the emergence of mechanistic studies suggests a transition from purely associative observations toward functional and translational investigation. Future studies should be designed to better define microbial roles by integrating standardized methodologies with multiomics approaches and detailed clinical phenotyping. Until such evidence emerges, microbiome research is best viewed as advancing biological insight rather than informing clinical decision-making.
Update on topography and tomography for refractive surgery.
Fernandes VM, McGlone C, Fernandez KB … +1 more , Rocha KM
Curr Opin Ophthalmol · 2026 Jul · PMID 42101181 · Publisher ↗
PURPOSE OF REVIEW: To review and summarize the current literature on recent advances in corneal topography and anterior segment tomography, highlighting emerging technological advances and the integration of artificial i...
PURPOSE OF REVIEW: To review and summarize the current literature on recent advances in corneal topography and anterior segment tomography, highlighting emerging technological advances and the integration of artificial intelligence, and their clinical applications in screening, planning, and optimizing outcomes of modern refractive surgery. METHODS: A comprehensive review of the recent literature was conducted using the PubMed, Scopus, and Web of Science databases to identify peer-reviewed articles published within the last 18 months that focus on advancements in corneal imaging technologies, including Placido-based topography, Scheimpflug imaging, and swept-source anterior segment optical coherence tomography (SS-ASOCT). Comparative studies, diagnostic accuracy reports, and new indices and software for ectasia risk assessment were analyzed. RECENT FINDINGS: Recent innovations in corneal topography and tomography have greatly improved the ability to detect subclinical keratoconus, evaluate corneal biomechanics, and develop personalized surgical plans. The integration of 3D corneal mapping, epithelial thickness profiling, and artificial intelligence-based analysis has increased diagnostic accuracy and safety in refractive procedures. These developments enable earlier detection of at-risk corneas and more accurate prediction of postoperative stability. SUMMARY: Advances in topography and tomography continue to improve the safety and predictability of refractive surgery. The use of multimodal imaging and AI-based diagnostics is transforming preoperative assessment and postoperative care, leading to more personalized and reliable visual outcomes.
Optical coherence tomography angiography in retinal vascular disease: transformative tool or expensive gimmick?
Mayeda MS, de Carlo Forest TE
Curr Opin Ophthalmol · 2026 Apr · PMID 42080494 · Publisher ↗
PURPOSE OF REVIEW: Optical coherence tomography angiography (OCTA) has rapidly evolved from an experimental imaging technique into a routine component of many retina practices. By providing noninvasive, depth-resolved vi...
PURPOSE OF REVIEW: Optical coherence tomography angiography (OCTA) has rapidly evolved from an experimental imaging technique into a routine component of many retina practices. By providing noninvasive, depth-resolved visualization of retinal and choroidal vasculature without dye injection, OCTA promises safer, faster, and more detailed assessment of retinal vascular disease than fluorescein angiography. However, there is still debate about its clinical applicability and its role in everyday ophthalmology practice, which we review in this article. RECENT FINDINGS: Over the past decade, OCTA has been extensively applied to diabetic retinopathy, retinal vein occlusion, sickle cell retinopathy, and other ischemic disorders, generating a growing body of literature linking OCTA-derived metrics to disease severity and visual outcomes. Despite this enthusiasm, significant limitations remain, including susceptibility to artifacts, restricted field of view, inability to demonstrate vascular leakage, and uncertain impact on management decisions. SUMMARY: We critically evaluate the current role of OCTA in retinal vascular disease by reviewing recently published literature. This review examines OCTA's technical foundations, clinical applications, strengths, limitations, and future directions. We argue that OCTA is neither a replacement for conventional angiography nor a mere technological novelty, but rather a powerful complementary imaging modality whose value depends on appropriate interpretation and thoughtful clinical integration.
Secondary intraocular fixation: anterior vs. posterior segment approaches, middle segment surgery, and emerging artificial capsule technologies.
Acaba-Berrocal L, Gupta OP, Ayres BD … +1 more , Kuriyan AE
Curr Opin Ophthalmol · 2026 Apr · PMID 42080464 · Publisher ↗
PURPOSE OF REVIEW: To review current and emerging advances in secondary intraocular lens (IOL) fixation in the absence of capsular support, emphasizing contemporary techniques, surgical outcomes, complication, and decisi...
PURPOSE OF REVIEW: To review current and emerging advances in secondary intraocular lens (IOL) fixation in the absence of capsular support, emphasizing contemporary techniques, surgical outcomes, complication, and decision making across anterior segment-based, posterior segment-based, and iris-based approaches, while discussing the growing role of middle segment surgery. RECENT FINDINGS: Practice patterns have shifted away from anterior chamber IOLs toward posterior chamber fixation, driven by advances in small-gauge vitrectomy, improved suture materials, refined scleral-fixation strategies, and dedicated fixation IOL designs. Contemporary options include anterior chamber IOLs, iris-sutured and iris-claw lenses, sutured scleral fixation using polypropylene or expanded polytetrafluoroethylene (Gore-Tex), and sutureless intrascleral haptic fixation techniques such as the Yamane method. Comparative evidence suggests that no single technique is universally superior, rather, procedures demonstrate broadly similar visual outcomes but distinct complication profiles. Middle segment surgery, proposing pars plana-based management of lens and capsular pathology by anterior segment surgeons has gained recent attention. In parallel, early clinical experience with artificial capsule technologies suggests a potential pathway to restore a capsular-like scaffold, expand IOL options, and improve refractive predictability. SUMMARY: Modern techniques have improved safety and outcomes of secondary IOL fixation. Surgical choice should be individualized, and emerging technologies may further redefine posterior chamber reconstruction.
Advances in cataract surgery: is a new era on the horizon?
Zhang X, Yu Y, Yao K
Curr Opin Ophthalmol · 2026 Jul · PMID 41936132 · Full text
PURPOSE OF REVIEW: To summarize recent technological, procedural and material advances that are reshaping cataract surgery and to appraise their implications for visual outcomes, safety and global accessibility. RECENT F...
PURPOSE OF REVIEW: To summarize recent technological, procedural and material advances that are reshaping cataract surgery and to appraise their implications for visual outcomes, safety and global accessibility. RECENT FINDINGS: Phacoemulsification remains the gold-standard technique, yet refinements in fluidics, ultrasound modulation and heads-up 3-D visualization continue to enhance efficiency and surgeon ergonomics. Femtosecond laser assistance yields measurable benefits in dense or unstable lenses but offers comparable long-term vision to modern phaco in routine cases. Presbyopia-correcting optics have diversified: trifocal and extended-depth-of-focus lenses deliver high rates of spectacle independence, light-adjustable lenses permit postoperative power customization, and early fluid-based or dual-optic accommodative models show 2-2.5 D of true accommodation. Intraoperative tool, digital overlays, aberrometry, microscope-integrated optical coherence tomography, and artificial intelligence-driven video analytics increase refractive precision and aid training. Drug-eluting and nanopatterned intraocular lenses, portable low-cost equipment and sustainability initiatives address comorbidity management, access and environmental impact. SUMMARY: Cataract surgery is evolving into a comprehensive, personalized ocular-rehabilitation procedure that corrects refractive error, treats coexisting disease and maximizes visual quality. Parallel efforts to expand workforce capacity, reduce costs and minimize waste are essential to ensure these innovations benefit patients worldwide.
Retinal diseases: Current medical and surgical updates and a look to the future.
Sridhar J, Kuriyan AE
Curr Opin Ophthalmol · 2026 May · PMID 41886768 · Publisher ↗
Abstract loading — click title to view on PubMed.
Canaloplasty and trabecular bypass glaucoma surgery: indications and outcomes.
Tan NE, Young CEC, Seibold LK
Curr Opin Ophthalmol · 2026 May · PMID 41881069 · Publisher ↗
PURPOSE OF REVIEW: Trabecular bypass stents and ab interno canaloplasty are popular micro-invasive glaucoma surgery approaches. This review summarizes recent evidence on outcomes, safety, and comparative effectiveness of...
PURPOSE OF REVIEW: Trabecular bypass stents and ab interno canaloplasty are popular micro-invasive glaucoma surgery approaches. This review summarizes recent evidence on outcomes, safety, and comparative effectiveness of these procedures. RECENT FINDINGS: Five to 7-year studies of the iStent and Hydrus combined with cataract surgery report sustained efficacy, slower visual field progression, and cost-effectiveness versus cataract surgery alone. However, position-related inflammatory and endothelial concerns have emerged for the Hydrus. Canaloplasty via several modalities can achieve intraocular pressure (IOP) reductions of 30-40% and medication reductions up to 60%, through as long as 6 years of follow-up, with few complications. Regarding standalone delivery, prospective data supports the use of the iStent infinite in refractory glaucoma. Standalone canaloplasty evidence is strongest for the OMNI and iTrack devices, while early STREAMLINE device outcomes are promising. Comparative studies find that the Hydrus may outperform earlier-generation iStents but not the iStent infinite; canaloplasty with the STREAMLINE device demonstrates near-equivalence to iStent inject W; and gonioscopy-assisted transluminal trabeculotomy achieves lower IOP than viscodilation, albeit with more frequent hyphema. SUMMARY: Both trabecular bypass and canaloplasty are effective interventions for open-angle glaucoma. Stents have the largest evidence base, while canaloplasty may offer similar efficacy without implant-related concerns.
Nutritional supplements: current evidence for retinitis pigmentosa and Stargardt disease.
Barthelemy N, Lee W, Gregori NZ … +2 more , Lam BL, Sengillo JD
Curr Opin Ophthalmol · 2026 May · PMID 41861379 · Full text
PURPOSE OF REVIEW: Inherited retinal diseases (IRDs) are genetically and phenotypically heterogeneous disorders that cause progressive vision loss and lack broadly effective disease-modifying therapies. Increasing eviden...
PURPOSE OF REVIEW: Inherited retinal diseases (IRDs) are genetically and phenotypically heterogeneous disorders that cause progressive vision loss and lack broadly effective disease-modifying therapies. Increasing evidence implicates metabolic stress, oxidative injury, and photoreceptor-retinal pigment epithelium (RPE) dysfunction in IRD pathophysiology. This review evaluates the evidence and limitations surrounding nutritional and metabolic interventions for retinitis pigmentosa and Stargardt disease.A narrative review of preclinical studies, randomized controlled trials, and contemporary genetic re-analyses was performed. Nutritional interventions reviewed include vitamin A, vitamin E, N-acetylcysteine (NAC), omega-3 fatty acids (docosahexaenoic acid), carotenoids and apocarotenoids, and the deuterated vitamin A analog C20-D3-retinyl acetate (ALK-001). RECENT FINDINGS: Initial studies suggesting a protective effect of vitamin A in retinitis pigmentosa were not confirmed in subsequent trials or genetic re-analyses, which identified baseline differences between groups as a possible contributor to the original findings. In contrast, supplemental vitamin E may accelerate disease progression. NAC demonstrated acceptable tolerability and modest short-term improvements in visual function in early-phase trials, with a phase 3 study ongoing. Omega-3 fatty acids, carotenoids, and apocarotenoids have not shown consistent clinically meaningful benefit in retinitis pigmentosa or Stargardt disease despite strong mechanistic rationale. In Stargardt disease, ALK-001 reduces lipofuscin accumulation in animal models and clinical trials are ongoing to assess efficacy in patients. SUMMARY: Most nutritional supplements studied to date have not demonstrated durable or clinically meaningful benefit in IRDs. Vitamin A supplementation in retinitis pigmentosa is no longer supported by current evidence, while NAC remains a promising metabolic therapy under investigation. High-quality, genotype-informed clinical trials with clinically relevant endpoints are needed before nutritional interventions can be incorporated into IRD management guidelines.
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