Therapeutic Value and Optical Performance of Small-Aperture Intraocular Implants: A Systematic Review

Area of Science:

• Ophthalmology
• Optical Engineering
• Biomedical Devices

Background:

• Conventional intraocular lens (IOL) implantation faces challenges like complex selection and limited correction of aberrations.
• Novel small-aperture optics leverage pinhole principles to enhance IOL functionality.

Purpose of the Study:

• To review the therapeutic value and optical performance of small-aperture intraocular implants.
• To synthesize evidence on the efficacy and safety of this emerging IOL technology.

Main Methods:

• Conducted a PRISMA 2020-compliant review of clinical and preclinical studies.
• Searched major databases including PubMed, Scopus, Medline, ScienceDirect, Cochrane Library, and ClinicalTrials.

Main Results:

• Small-aperture IOLs improve uncorrected visual acuity and depth of focus, reducing spectacle dependence.
• Engineering design minimizes higher-order aberrations, improving tolerance to ametropia and image quality in complex cases.
• High patient satisfaction reported; explantation is rare, but careful patient selection is crucial.

Conclusions:

• Small-aperture IOLs are advantageous for presbyopia, inaccurate biometry, irregular astigmatism, and complex anterior segment disorders.
• These implants offer a viable alternative when conventional IOLs are unsuitable or ineffective.
• Understanding optical principles guides optimized implantation strategies for enhanced patient outcomes.