To explore the influencing factors of posterior capsular opacification (Posterior Capsular Opacification, PCO) after intraocular lens implantation treated with Nd: YAG(Neodymium: Yttrium-Aluminum-Garnet) laser and to establish a predictive model to evaluate its risk.

From January 2018 to June 2023, the data of 312 patients with posterior capsule opacification and Nd: YAG laser treatment in our hospital were retrospectively analyzed. All patients were randomly divided into training group (218 cases) and verification group (94 cases) at the ratio of 7:3. In the training set, the independent risk factors of posterior capsule opacification before operation were identified by multivariate Logistic regression analysis, and the nomogram prediction model was constructed. By drawing ROC (receiver operating characteristic) curve and calibration curve, the prediction effectiveness of the model is evaluated, and the verification is carried out in the verification set, and its clinical application value is explored by Decision Curve Analysis (DCA).

Among 312 patients, 84 (22.92%) developed PCO. The logistic results showed that age ≥ 60 years, extracapsular excision surgery, multifocal intraocular lens, axial length ≥ 24 mm, preoperative visual acuity < 0.3, high laser energy, and large posterior capsule incision aperture were associated with the occurrence of PCO (P < 0.05). The C-index indexes of the nomograph model were 0.870 and 0.842 in the training set and verification set, respectively, and the average was absolute. In the Hosmer-Lemeshow test, the χ2 values of the training set and the verification set are 4.007(P = 0.856) and 2.841(P = 0.943), respectively. The ROC curve shows that the AUC(Area Under Curve) values of the training set and the verification set are 0.870 (95% CI: 0.810-0.929) and 0.843 (95% CI: 0.732-0.954) respectively, and the combination of sensitivity and specificity is 0.792, 0.810, 0.765 and 0.792 respectively.

The nomogram prediction model based on Nd: YAG laser treatment of PCO risk factors after intraocular lens implantation has high accuracy and calibration, which can provide a key reference for formulating preventive measures, help to reduce the incidence of PCO and improve the prognosis of patients.

Cataract surgery including intraocular lens (IOL) insertion, has been refined extensively since the first such procedure by Sir Harold Ridley in 1949. The intentional creation of monovision with IOLs using monofocal IOL designs has been reported since 1984. The first reported implantation of multifocal IOLs was published in 1987. Since then, various refractive and or diffractive multifocal IOLs have been commercialised. Most are concentric, but segmented IOLs are also available. The most popular are trifocal designs (overlaying two diffractive patterns to achieve additional focal planes at intermediate and near distances) and extended depth of focus designs which leave the patient largely spectacle independent with the reduced risk of bothersome contrast reduction and glare. As well as mini-monovision, surgical strategies to minimise the impact of presbyopia with IOLs includes mixing and matching lenses between the eyes and using IOLs whose power can be adjusted post-implantation. Various IOL designs to mimic the accommodative process have been tried including hinge optics, dual optics, lateral shifts lenses with cubic-type surfaces, lens refilling and curvature changing approaches, but issues in maintaining the active mechanism with post-surgical fibrosis, without causing ocular inflammation, remain a challenge. With careful patient selection, satisfaction rates with IOLs to manage presbyopia are high and anatomical or physiological complications rates are no higher than with monofocal IOLs.

Presbyopia is often the first sign of ageing experienced by humans. Standardising terminology and adopting it across the BCLA CLEAR Presbyopia reports, improves consistency in the communication of the evidence-based understanding of this universal physiological process. Presbyopia can be functionally and psychologically debilitating, especially for those with poor access to eyecare. Presbyopia was defined as occurring when the physiologically normal age-related reduction in the eye's focusing range reaches a point that, when optimally corrected for far vision, the clarity of vision at near is insufficient to satisfy an individual's requirements. Accommodation is the change in optical power of the eye due to a change in crystalline lens shape and position, whereas pseudo-accommodation is the attainment of functional near vision in an emmetropic or far-corrected eye without changing the refractive power of the eye. Other definitions specific to vision and lenses for presbyopia were also defined. It is recommended that these definitions be consistently adopted in order to standardise future research, clinical evaluations and education.

Cataracts pose a significant clinical burden due to their complex pathogenesis. In recent years, an increase in cataracts coexisting with myopia has heightened the incidence of retinopathy and posterior vitreous detachment. Additionally, symptoms of ocular axis elongation, lens nucleus hardening, and vitreous liquefaction have become more prevalent. While conventional extracapsular cataract extraction is commonly employed, it often yields suboptimal visual outcomes. Subsequent advancements in cataract phacoemulsification and lens implantation surgeries have gained widespread acceptance for their ability to improve refraction and significantly improve uncorrected visual acuity.

To investigate the effect of capsular treatment after phacoemulsification lens implantation in myopic patients with cataract.

We selected 110 patients (with 134 eyes) with myopia and cataracts treated. These patients were categorized into two groups: an observation group (57 patients with 70 eyes) and a control group (53 patients with 64 eyes). The control group underwent cataract phacoemulsification and lens implantation, while the observation group received a refined capsular treatment based on the control group's procedure. We assessed the differences in visual acuity and quality between the two groups before and after surgery.

At six months post-operation, the observation group exhibited significantly improved far vision, intermediate vision, near vision, lower objective scattering index, higher Modulation transfer function cut-off frequency, and overall vision metrics at different contrast levels (100%, 20% and 9%) compared to the control group (P < 0.05). The total score of the National Eye Institute Visual Function Questionnaire in the observation group at 6 months after operation was significantly higher than that in the control group (P < 0.05). No significant difference in the incidence of adverse reactions was observed between the observation group and control group (P > 0.05).

Capsular treatment demonstrates efficacy in improving visual acuity and quality after phacoemulsification lens implantation in myopic patients with cataracts, warranting its clinical application.

To report the initial safety and effectiveness profile for an anterior shape-changing, modular IOL, Juvene (JIOL), for the treatment of aphakia and presbyopia after removal of the natural crystalline lens due to cataract.

Two private practices in Monterrey and Tijuana, Mexico.

Exploratory, prospective, multi-center, open-label, non-comparative clinical trial.

A convenience sample of subjects aged 50-80 years with planned cataract surgery were recruited to undergo unilateral or bilateral implantation with the JIOL. Subjects were required to complete an informed consent and be able to dilate to at least 6.0 mm pharmacologically, be in good overall health, and have no significant eye health history to qualify. Visual acuities, defocus curves, and contrast sensitivity were measured for all subjects 12 months postoperatively.

Fifty-one of 58 eyes completed the 12-month visit. Intraoperative complication rates were extremely low (N=1; missed base lens tab). The most frequent adverse events (AE) were prolonged inflammation (N=6) and cystoid macular edema (N=4); all AEs were resolved without sequelae by the 12-month visit. Mean monocular logMAR corrected distance visual acuity (CDVA), distance-corrected intermediate (DCIVA) and near (DCNVA) were 0.01, 0.08, and 0.24, respectively. Defocus testing showed VA > 20/40 from approximately +1.00 D through -2.00 D. Binocular implantation (n=16) provided superior performance over monocular implantation.

The Juvene IOL offers a novel solution to treat presbyopia, providing clear functional vision performance across a range of distances with an acceptable initial safety profile.