Joukje C Wanten, Victoria Till, Oliver Findl, Béatrice Cochener-Lamard, Thomas Kohnen, Rudy M M A Nuijts, ESCRS Cataract Surgery Guidelines Working Group
Cataract is a leading cause of visual impairment globally, with surgery as the only effective treatment. Management involves a care pathway, including screening, patient selection, preoperative assessment, surgery, and postoperative care. The ESCRS developed evidence-based guidelines to aid decision-making for patients, clinicians, and stakeholders. A multidisciplinary panel, supported by methodologists using the Grading of Recommendations, Assessment, Development, and Evaluations approach, addressed 32 key clinical questions. Recommendations include intracameral antibiotics to prevent endophthalmitis, topical anesthesia as the preferred technique, and toric intraocular lenses for corneal astigmatism ≥1.0 diopter. Conventional and femtosecond laser-assisted surgeries are comparably safe and effective. Nonsteroidal anti-inflammatory drug eyedrops, alone or with corticosteroids, are recommended to reduce inflammation and prevent cystoid macular edema. Additional guidance includes shared decision-making for lens selection, safe use of immediate sequential bilateral cataract surgery, and potential of remote postoperative care to enhance healthcare efficiency. These guidelines aim to improve outcomes, patient experience, and care delivery.