Fuente: PubMed "essential OR oil extract" Ann Biomed Eng. 2026 Jun 21. doi: 10.1007/s10439-026-04244-0. Online ahead of print.ABSTRACTINTRODUCTION: Intraocular lens (IOL) implantation is a well-established surgical procedure for managing common conditions such as cataract and refractive errors. However, conventional IOLs present several clinical challenges, including a complex lens selection process, limited tolerance to residual ametropia, and the inability to effectively correct corneal aberrations or irregular astigmatism. To overcome these limitations, a novel technology based on small-aperture optics has been developed, leveraging pinhole principles to modify depth of focus and optical system behavior.PURPOSE: To synthesize the available evidence on small-aperture intraocular implants, focusing on their therapeutic value and optical performance.METHODS: A review of clinical and preclinical studies, including full-text articles, case reports and clinical trials, was conducted across databases (PubMed, Scopus, Medline, ScienceDirect, Cochrane Library, and ClinicalTrials), following the PRISMA 2020 guidelines.RESULTS: Small-aperture implants improve uncorrected visual acuity, extend depth of focus, and reduce spectacle dependence. From an engineering perspective, their design reduces the impact of higher-order aberrations, thereby increasing tolerance to residual ametropias and enhancing image quality in patients with corneal irregularities, iris defects, or other anterior segment comorbidities. Overall patient-reported satisfaction is high, and both unilateral and bilateral implantation strategies are feasible. However, retinal visualization may be partially limited, and some patients may experience scotopic intolerance related to reduced light transmission. Explantation due to poor adaptation is uncommon; nevertheless, careful patient selection remains essential. No other major adverse effects have been reported.CONCLUSION: Small-aperture intraocular implants represent an advantageous strategy for managing multiple conditions, including presbyopia, eyes with inaccurate biometry, irregular astigmatism, and complex anterior segment disorders, particularly when conventional IOLs may be ineffective or unsuitable. By linking clinical performance to optical principles of small-aperture implants, this review provides insight into the functional rationale of small-aperture implants and informs strategies for optimized implantation.PMID:42323773 | DOI:10.1007/s10439-026-04244-0