Abstract: Posterior capsular opacification(PCO) is a condition in which lens epithelial cells (LEC) undergo inflammatory and epithelial-mesenchymal transition after cataract extraction surgery, leading to increased  proliferation, migration, and extracelluar matrix deposition of LEC, ultimately manifesting as the formation of surface deposits on the lens posterior capsule.  Although posterior capsulotomy with YAG laser is the  first-line treatment for PCO, but it still has certain limitations. Although research on the mechanism of PCO has gradually deepened, there are currently no approved drugs specifically for the prevention or treatment of PCO in clinical practice, and most of the drugs currently used for research are in the in vitro and in vivo experimental  practice. The drugs, such as nonsteroidal anti-inflammatory drugs, immunosuppressants, anti mitotic drugs, and traditional Chinese medicine extracts, applied to prevent PCO are mostly in the vitro and  vivo experimental stages and have not yet been widely used in clinic. In addition, the development of biomaterials and drug-sustained delivery systems also provide possible strategies for targeted pharmacological intervention. However, the main challenge currently faced is effectively inhibiting LEC proliferation while avoiding damage to other structures in the ocular. Therefore, future investigation should focus on drug safety and  the expansion of treatment windows. More precise and safer drug delivery systems should also be developed. (Int Rev Ophthalmol, 2025, 49:  101-108)

Key words: posterior capsular opacification, non-steroidal anti-inflammatory drugs, immunosuppressants, antimetabolites, autophagy regulation, enzyme inhibitors, monomers of traditional Chinese medicine