ESCRS guideline for cataract surgery 2024: executive summary
In brief
Toric intraocular lenses improve outcomes for eyes with at least 1 diopter astigmatism
The 2024 ESCRS cataract surgery guideline advises using toric lenses whenever corneal astigmatism is 1.0 diopter or greater, citing evidence that they correct astigmatism more effectively than standard lenses. It also recommends intracameral antibiotics to lower infection risk, topical anesthesia as the preferred technique, and NSAID eye drops to curb inflammation and cystoid macular edema, while noting laser-assisted and conventional surgery are equally safe.
- Journal
- Journal of cataract and refractive surgery (Q1)
- Published
- 1 September 2026
- Study design
- Practice guideline / consensus
- Evidence level
- Level 1, High (CEBM 1c)
- Authors
- Joukje C Wanten, Victoria Till, Oliver Findl, Béatrice Cochener-Lamard, Thomas Kohnen, Rudy M M A Nuijts
- PMID
- 42674864
- DOI
- 10.1097/j.jcrs.0000000000002012
Why clinicians should know about it
- Picked for Ophthalmology (top studies of the week, 6 September 2026): ESCRS cataract surgery guideline, practice-changing recommendations
Abstract
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.