后发性白内障(PCO)是白内障术后常见并发症，由残余晶状体上皮细胞(LECs)增殖迁移引发。虽然掺钕钇铝石榴石(Nd：YAG)激光后囊切开术可治疗PCO，但可能引起黄斑囊样水肿等并发症，因此从源头预防PCO的形成更具临床意义。尽管人工晶状体(IOL)的材料与设计不断改进，但难以彻底消除PCO。文章综述了新型表面改性IOL的研究进展，包括抗生物污染IOL(减少LECs黏附)、增强黏连IOL(促进囊袋贴合)、微图案IOL(物理抑制迁移)、光热/光动力IOL(光诱导LECs凋亡)及载药IOL(缓释药物)。这些改性技术通过物理、化学或生物活性机制协同抑制LECs增殖，显著降低PCO发生率，同时规避了激光治疗的潜在风险。文章旨在为IOL优化设计提供参考，推动白内障手术从被动治疗转向主动预防，对改善患者长期预后具有重要价值。

Posterior capsule opacification(PCO)is a common postoperative complication of cataract surgery, primarily caused by the proliferation and migration of residual lens epithelial cells(LECs). Although neodymium-doped yttrium aluminum garnet(Nd:YAG)laser posterior capsulotomy effectively treats PCO, it carries risks of complications such as cystoid macular edema(CME). Thus, preventing PCO formation is of critical clinical importance. Despite advancements in intraocular lens(IOL)materials and designs, achieving complete PCO eradication remains challenging. This review systematically examines recent advancements in surface-modified IOLs, including anti-biofouling IOL(reducing LECs adhesion), capsular adhesion-enhanced IOL(promoting capsular bag integration), micro-patterned IOL(physically inhibiting migration), photothermal/photodynamic IOL(inducing light-activated LECs apoptosis), and drug-eluting IOL(sustained drug release). These surface modification strategies demonstrate synergistic effects through complementary mechanisms(including physical barrier formation, chemical intervention, and bioactive regulation), effectively suppressing LECs proliferation while significantly reducing PCO incidence. Importantly, these approaches eliminate the risks associated with conventional Nd:YAG laser treatment, offering substantial advantages. By providing a comprehensive evaluation of these cutting-edge technologies, this review serves as a valuable reference for IOL design optimization. It represents a paradigm shift in cataract management strategies, transitioning from reactive therapeutic interventions to proactive preventive measures, and ultimately leads to improving long-term visual outcomes for patients.

河北省医学科学研究课题计划(No.20250250)