CURRENT OPINION IN OPHTHALMOLOGY

Manual small incision cataract surgery
Winterton C, Mai A and Pettey J
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.
Cataract surgery in patients with diabetes mellitus: preoperative, intraoperative, and postoperative considerations
Garcia-Cabrera CR and Afshari NA
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.
Toward autonomous discovery: agentic AI and the future of ophthalmic research
Soetikno BT, Nielsen CS, Pollreisz A and Ting DSW
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.
Toric intraocular lenses: advancements in astigmatism correction
Wallace RT, Balakrishnan UL and Weikert MP
Toric intraocular lenses (IOL) predictably correct corneal astigmatism and are an important part of the cataract and refractive surgeon's toolbox.
Surgical techniques for complicated cataracts: managing dense or white cataracts
Ahad MA and Almazyad EM
To review recent advances in the surgical management of dense white cataracts, focusing on preoperative assessment, biometry, capsulotomy techniques, phacoemulsification systems, and surgical outcomes.
Beyond the phaco tip: is artificial intelligence the next frontier in cataract surgery?
Garcia-Cabrera CR and Afshari NA
The evolving fate of the corneal endothelium in cataract surgery
Folk GA and Afshari NA
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.
Impact of insurance status on toric premium intraocular lens selection for patients undergoing cataract surgery with astigmatism
Ashby CK, Sitto MM, Sant DW and Moshirfar M
To evaluate the association between insurance status and the selection of toric premium intraocular lenses (IOLs) among patients undergoing cataract surgery with astigmatism.
Middle segment surgery: indications, techniques, and future directions
Hannush SB, Chayet A and Ifantides C
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.
Presbyopia-correcting intraocular lenses in eyes with corneal conditions: an update
McNeely RN, Moore JE, Mehta JS and Ting DSJ
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.
Cataract surgery in keratoconus: current challenges and future directions
Sarnicola C, Sarnicola E and Sarnicola V
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.
Eying up predatory bacteria: living antimicrobials for ocular infections
Shanks RMQ, Romanowski EG, Patel DR and Kadouri DE
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.
Big data in ophthalmology: comparative databases and research applications
Ayoubi M, Sayed MS, Khodeiry MM, Elhusseiny AM and Lee RK
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.
Antifibrotics in glaucoma surgery: current practices and future directions
Santilli C and Sheheitli H
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.
Glaucoma management reconsidered: insights from LiGHT, ZAP, TAGS, PTVT, and EAGLE
Taylor K, Mosenia A and Bowden EC
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.
COVID-19: ocular manifestations and associations with corneal transplant rejection and uveitis reactivation
Saban O, Doan T and Seitzman GD
To highlight the ocular manifestations associated with COVID-19 and review the evidence surrounding proposed associations with corneal transplant rejection and uveitis reactivation.
Evaluation of ophthalmic large language models: quantitative vs. qualitative methods
Tan TF, Thirunavukarasu AJ, Quek C and Ting DSW
Alongside the development of large language models (LLMs) and generative artificial intelligence (AI) applications across a diverse range of clinical applications in Ophthalmology, this review highlights the importance of evaluation of LLM applications by discussing evaluation metrics commonly adopted.
Artificial intelligence oculomics for systemic health and longevity medicine: 2025 and beyond
Yao J, Hong ASY, Fukutsu K and Ting DSW
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.
The utility of artificial intelligence in ophthalmic clinical trials
Nath S, Rahimy E, Kras A and Korot E
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.
Novel artificial intelligence applications for pediatric retina
Antonio-Aguirre B, Gadiraju A, Ownagh V and Vajzovic L
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.
Accelerating insight: the role of artificial intelligence in health economic analysis for ophthalmology
Nielsen CS, Soetikno BT, Pollreisz A and Ting DSW
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.