RT Journal Article SR Electronic T1 Structure of the lens and its associations with the visual quality JF BMJ Open Ophthalmology JO BMJ Open Ophth FD BMJ Publishing Group Ltd SP e000459 DO 10.1136/bmjophth-2020-000459 VO 5 IS 1 A1 Xiaoting Ruan A1 Zhenzhen Liu A1 Lixia Luo A1 Yizhi Liu YR 2020 UL http://bmjophth.bmj.com/content/5/1/e000459.abstract AB In humans, the lens is the organ with the ability to change morphology and refractive power, designated as accommodation, to focus light from various distances and obtain clear retinal image. The accommodative ability of the lens depends on its structure and biological parameters. The lens grows throughout the life, forming specific lens sutures and a unique gradient refractive index, and possesses regenerative ability under certain circumstances. Minimally invasive lens surgery that preserves endogenous lens epithelial stem/progenitor cells (LECs) can achieve functional lens regeneration in humans. The lens is the main source of intraocular aberration, especially intraocular higher-order aberrations (IHOAs) which is found to be binocularly symmetrical in phakic eyes. There is a compensation mechanism between corneal aberrations and lens aberrations. Therefore, the structure and the biological parameters of the lens, the binocular relationship of the lens and the correlation between the lens and cornea affect visual quality. This paper summarises the above findings and their current and potential applications in refractive surgeries, providing a comprehensive understanding of the lens as a strong determinant of visual quality in the optical system.