Cataract: Surgery first - is there still room for basic research?

Background: Cataract is the leading cause of blindness worldwide, with surgery being the only effective treatment. Driven by advanced techniques and innovative functional intraocular lenses (IOLs), cataract surgery has achieved a remarkable paradigm shift from vision restoration to refractive surgery. This dominance of surgery raises a core question: Is there still room for basic research? Main text: Basic research remains vital to addressing unmet challenges in cataract care. The lens serves as an ideal biological model for studying fundamental processes. In addition, efforts to enable cataract prevention and early intervention focus on investigating its etiology, including genetic susceptibility and environmental exposure. Pharmacological research investigates potentials for delaying or even reversing early-stage lens opacification. For intraocular lens (IOL) performance enhancement, advances in material science boost biocompatibility of IOLs, while insights from lens biomechanics further refine IOL design for better long-term stability. To address posterior capsule opacification (PCO), a key postoperative issue, efforts center on developing drug-coated IOLs and sustained-release delivery systems. Lastly, lens regeneration research explores activating residual lens epithelial cells (LECs) for in situ regeneration and tackles challenges in culturing functional lens tissue in vitro. Conclusions: The success of cataract surgery does not diminish the value of basic research. Instead, collaboration between clinicians and basic researchers, along with increased investment in basic research, will drive breakthroughs in cataract prevention and treatment, enabling natural, long-term vision beyond just clear sight.