Multicenter Study on the Use of Intraoperative OCT in the Diagnosis and Management of Lens Diseases

Lens disorders, particularly cataract, are a leading cause of blindness worldwide and substantially impair quality of life. Surgery remains the most effective treatment, but pre-existing abnormalities of the lens and adjacent ocular structures, together with unexpected intraoperative events, may increase surgical complexity and affect outcomes. Accurate assessment of anterior segment structures is therefore essential, as abnormalities caused by trauma, congenital disorders, ocular diseases, or systemic conditions may involve the lens, capsule, cornea, iris, or anterior chamber angle. Even during routine phacoemulsification, variations in irrigation pressure, anterior chamber depth, capsular bag integrity, capsular expansion, and residual cortex may influence surgical safety, IOL centration, and postoperative refractive stability. Because some abnormalities cannot be reliably detected preoperatively, intraoperative optical coherence tomography (iOCT) may provide real-time structural information and support surgical decision-making. However, evidence regarding its effects on surgical strategy, visual outcomes, refractive stability, and complications remains limited. This multicenter retrospective study will assess the associations between preoperative and intraoperative anterior segment changes and postoperative outcomes, and evaluate the clinical value of iOCT in lens surgery.

Inclusion criteria

• Patients aged 18 years or older with lens opacity or abnormal lens position, whose visual function was insufficient for daily activities, who met the indications for surgery, and who had undergone lens surgery.

Exclusion criteria

• 1. Patients aged 18 years or older with lens opacity or abnormal lens position, whose visual function was insufficient for daily activities, who met the indications for surgery, and who had undergone lens surgery.

• Active intraocular inflammation. 3. Uncontrolled systemic disease, use of medications that could significantly affect surgery, or other standard contraindications to lens surgery.

• Incomplete or unreliable key preoperative examination data, including ocular biometry.

• Inadequate image quality due to poor fixation or other causes, rendering the images unsuitable for analysis.

6.Incomplete intraoperative OCT recordings, such as interrupted recording or severe image freezing, affecting data evaluation.

• Other psychological or physical conditions that might interfere with study participation.