Most studies evaluating cataract surgery focus on the primary outcome of early, central, best-corrected visual acuity. However, cataract surgery and intraocular lens (IOL) design have other secondary visual outcomes as well as impacts on various ocular tissues, the visual function, and quality of life. Some of these aspects are more difficult to quantify, or are historically neglected, but might be extremely important to patients. One important development was the addition of blue-light filtering to IOL design. Whether these IOLs truly have the retinal protective qualities they were designed for is disputed, yet other inadvertent desirable and possibly detrimental influences are being examined. Risk of falls, driving accidents, and other injuries decrease following cataract surgery, especially in the elderly, the importance of which cannot be overemphasized. Cataract formation contributes to social isolation and decreases cognitive stimulation in the elderly population, while cataract extraction can reduce the risk of dementia and cognitive decline. Diffractive multifocal and extended depth-of-focus IOLs improve spectacle independence and patient reported outcomes, but positive and negative dysphotopsia may be persistent. Future directions such as using the IOL enabling clear spectacle-free vision at all distances, or intraoperative drug delivery systems show promising preliminary results. It seems inevitable that a higher focus on the secondary outcomes of surgery will increase. We believe that these aspects will become more and more relevant when considering new IOL designs and surgical techniques, a fact that will benefit both the patients and the surgeons.

大多数评估白内障手术的研究重点关注早期、中央、最佳矫正视力的主要结果。然而，白内障手术和人工晶状体（IOL）设计还有其他次要视觉结果，并对各种眼组织、视觉功能和生活质量产生影响。其中一些方面更难以量化，或者历史上被忽视，但对患者来说可能极其重要。一项重要的发展是在 IOL 设计中添加蓝光过滤功能。这些人工晶状体是否真正具有其设计时的视网膜保护特性尚存在争议，但其他无意的、有利的和可能有害的影响正在接受检查。白内障手术后跌倒、驾驶事故和其他伤害的风险降低，尤其是老年人，其重要性怎么强调都不为过。白内障的形成会导致老年人的社会孤立并减少认知刺激，而白内障摘除术可以降低痴呆和认知能力下降的风险。衍射多焦和扩展焦深人工晶状体可改善眼镜独立性和患者报告的结果，但正性和负性视差可能会持续存在。未来的方向，例如使用人工晶状体在所有距离实现清晰的无眼镜视力，或术中药物输送系统显示出有希望的初步结果。对手术次要结果的更多关注似乎不可避免。我们相信，在考虑新的 IOL 设计和手术技术时，这些方面将变得越来越重要，