{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:19:32Z","timestamp":1779337172741,"version":"3.51.4"},"reference-count":11,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T00:00:00Z","timestamp":1759190400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Posterior capsular opacification (PCO) remains the most common long-term complication following cataract surgery. This correspondence investigates whether intraocular lens (IOL) fixation type influences PCO risk by comparing Nd:YAG capsulotomy rates between capsulotomy-fixated (FEMTIS) and conventional in-the-bag IOLs with similar material and edge profiles. Methods: A systematic review was conducted. Eligible studies reporting quantitative YAG rates at \u22653 months of follow-up were included. Results: FEMTIS IOLs demonstrated lower capsulotomy rates (3.1% at 12 months) compared to in-the-bag LENTIS lenses (4.7% at 12 months), despite identical optic designs and identical material. Conclusions: This suggests that capsulotomy fixation may promote closer capsule\u2013optic contact and reduce the potential space for lens epithelial cell migration. While data are limited by study heterogeneity and follow-up duration, early evidence supports anterior fixation as a potential strategy to reduce PCO risk and improve long-term capsular clarity. Further prospective studies are warranted. Limitations include heterogeneous study designs, relatively short follow-up, and reliance on Nd:YAG capsulotomy as the sole endpoint.<\/jats:p>","DOI":"10.3390\/jcm14196947","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T09:37:21Z","timestamp":1759311441000},"page":"6947","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Analyzing the Relationship Between IOL Fixation and PCO Prevention"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1596-3529","authenticated-orcid":false,"given":"David","family":"Beckers","sequence":"first","affiliation":[{"name":"Precise Vision Ophthalmologists, 48 429 Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Kretz","sequence":"additional","affiliation":[{"name":"Precise Vision Ophthalmologists, 48 429 Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6362-4898","authenticated-orcid":false,"given":"Jodhbir","family":"Mehta","sequence":"additional","affiliation":[{"name":"Singapore National Eye Centre, Singapore 168751, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena","family":"Beckers","sequence":"additional","affiliation":[{"name":"Precise Vision Ophthalmologists, 48 429 Rheine, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1038\/sj.eye.6702661","article-title":"Effect of Posterior Capsular Opacification on Visual Function in Patients with Monofocal and Multifocal Intraocular Lenses","volume":"22","author":"Elgohary","year":"2008","journal-title":"Eye"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s13643-019-1113-6","article-title":"Effects of Cataract Surgery and Intra-Ocular Lens Implantation on Visual Function and Quality of Life in Age-Related Cataract Patients: A Systematic Review Protocol","volume":"8","author":"Jain","year":"2019","journal-title":"Syst. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"237","DOI":"10.59566\/IJBS.2007.3237","article-title":"Post-Operative Capsular Opacification: A Review","volume":"3","author":"Raj","year":"2007","journal-title":"Int. J. Biomed. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1001\/archophthalmol.2009.3","article-title":"Posterior Capsular Opacification: A Problem Reduced but Not yet Eradicated","volume":"127","author":"Awasthi","year":"2009","journal-title":"Arch. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100905","DOI":"10.1016\/j.preteyeres.2020.100905","article-title":"Posterior Capsule Opacification: What\u2019s in the Bag?","volume":"82","author":"Wormstone","year":"2021","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1016\/j.jcrs.2004.05.022","article-title":"Effect of Intraocular Lenses on Preventing Posterior Capsule Opacification: Design versus Material","volume":"30","author":"Nishi","year":"2004","journal-title":"J. Cataract. Refract. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Konopi\u0144ska, J., M\u0142ynarczyk, M., Dmuchowska, D.A., and Obuchowska, I. (2021). Posterior Capsule Opacification: A Review of Experimental Studies. J. Clin. Med., 10.","DOI":"10.20944\/preprints202104.0738.v1"},{"key":"ref_8","first-page":"1","article-title":"Posterior Capsule Opacification (PCO) Rate of a Hydrophilic Acrylic Intraocular Lens Suitable for Microincisional Cataract Surgery (MICS)","volume":"2","author":"Stylianides","year":"2020","journal-title":"Med. Clin. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.ajo.2020.09.046","article-title":"Comparison of Nd:YAG Laser Capsulotomy Rates Between Refractive Segmented Multifocal and Multifocal Toric Intraocular Lenses","volume":"222","author":"Kim","year":"2021","journal-title":"Am. J. Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000449124","article-title":"High Rate of Early Posterior Capsule Opacification Following Femtosecond Laser-Assisted Cataract Surgery","volume":"7","author":"Rostami","year":"2016","journal-title":"Case Rep. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ajo.2020.12.025","article-title":"Stability and Visual Outcomes of the Capsulotomy-Fixated FEMTIS-IOL After Automated Femtosecond Laser-Assisted Anterior Capsulotomy","volume":"225","author":"Auffarth","year":"2021","journal-title":"Am. J. Ophthalmol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6947\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:31:03Z","timestamp":1760070663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/19\/6947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,30]]},"references-count":11,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["jcm14196947"],"URL":"https:\/\/doi.org\/10.3390\/jcm14196947","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,30]]}}}