---
title: "ESCRS 2024 Cataract Surgery Guideline: Executive Summary and Key Recommendations"
id: "pubmed-42674864"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674864"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674864/"
doi: "10.1097/j.jcrs.0000000000002012"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# ESCRS 2024 Cataract Surgery Guideline: Executive Summary and Key Recommendations
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674864
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674864/)
- **DOI:** [10.1097/j.jcrs.0000000000002012](https://doi.org/10.1097%2Fj.jcrs.0000000000002012)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Cataract remains a leading cause of visual impairment worldwide and **surgery** is the only effective treatment option. The guideline frames cataract care as a full **care pathway** including screening, selection, preoperative assessment, surgery, and postoperative care. - The European Society of Cataract and Refractive Surgeons (ESCRS) produced evidence-based guidance developed by a multidisciplinary panel supported by methodologists using the **GRADE** approach. - The panel addressed 32 key clinical questions relevant to routine cataract practice and service delivery; recommendations are intended to assist clinicians, patients, and stakeholders. - Strong procedural and pharmacologic recommendations reported include routine use of **intracameral antibiotics** to prevent postoperative endophthalmitis and preference for **topical anesthesia** as the anesthesia technique of choice. - For refractive planning, the guideline recommends **toric intraocular lenses** for eyes with corneal astigmatism ≥1.0 diopter and endorses shared decision-making for lens selection. - The guideline states that **conventional** phacoemulsification and **femtosecond laser–assisted** cataract surgery have comparable safety and effectiveness based on available evidence. - To control inflammation and reduce the risk of **cystoid macular edema (CME)**, the panel recommends **nonsteroidal anti-inflammatory drug eyedrops**, either alone or combined with topical corticosteroids. - Guidance covers service delivery options: the safe use of **immediate sequential bilateral cataract surgery** in selected patients and the potential role of **remote postoperative care** to increase efficiency. - The guideline aims to improve patient outcomes, experience, and the organization of cataract care; further details and evidence gradings are reported in the full guideline. - The executive summary and recommendations were published as a practice guideline in J Cataract Refract Surg (2026) with DOI 10.1097/j.jcrs.0000000000002012.
## Clinical Analysis & Structured Key Points
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Vienna Institute for Research in Ocular Surgery \(VIROS\), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria \(Till, Findl\); Service d'Ophtalmologie, CHRU Brest, Brest, France \(Cochener-Lamard\); Université de Bretagne Occidentale, Brest, France \(Cochener-Lamard\); Department of Ophthalmology, Goethe University, Frankfurt, Germany \(Kohnen\)."), [Victoria Till](https://pubmed.ncbi.nlm.nih.gov/?term=Till+V&cauthor_id=42674864), [Oliver Findl](https://pubmed.ncbi.nlm.nih.gov/?term=Findl+O&cauthor_id=42674864), [Béatrice Cochener-Lamard](https://pubmed.ncbi.nlm.nih.gov/?term=Cochener-Lamard+B&cauthor_id=42674864), [Thomas Kohnen](https://pubmed.ncbi.nlm.nih.gov/?term=Kohnen+T&cauthor_id=42674864), [Rudy M M A Nuijts](https://pubmed.ncbi.nlm.nih.gov/?term=Nuijts+RMMA&cauthor_id=42674864); [ESCRS Cataract Surgery Guidelines Working Group](https://pubmed.ncbi.nlm.nih.gov/?term=ESCRS+Cataract+Surgery+Guidelines+Working+Group%5BCorporate+Author%5D) Collaborators, Affiliations Expand ### Collaborators * **ESCRS Cataract Surgery Guidelines Working Group** : [Adi Abulafia](https://pubmed.ncbi.nlm.nih.gov/?term=Abulafia+A), [Anders Behndig](https://pubmed.ncbi.nlm.nih.gov/?term=Behndig+A), [Alexander C Day](https://pubmed.ncbi.nlm.nih.gov/?term=Day+AC), [Catarina R Pedrosa](https://pubmed.ncbi.nlm.nih.gov/?term=Pedrosa+CR), [Dominique Monnet](https://pubmed.ncbi.nlm.nih.gov/?term=Monnet+D), [Filomena J Ribeiro](https://pubmed.ncbi.nlm.nih.gov/?term=Ribeiro+FJ), [Gerd U Auffarth](https://pubmed.ncbi.nlm.nih.gov/?term=Auffarth+GU), [Jorge L Alió](https://pubmed.ncbi.nlm.nih.gov/?term=Ali%C3%B3+JL), [Kjell G Gundersen](https://pubmed.ncbi.nlm.nih.gov/?term=Gundersen+KG), [Mayank A Nanavaty](https://pubmed.ncbi.nlm.nih.gov/?term=Nanavaty+MA), [Nino Hirnschall](https://pubmed.ncbi.nlm.nih.gov/?term=Hirnschall+N), [Nic J Reus](https://pubmed.ncbi.nlm.nih.gov/?term=Reus+NJ), [Peter Hoffmann](https://pubmed.ncbi.nlm.nih.gov/?term=Hoffmann+P), [Paul H Rosen](https://pubmed.ncbi.nlm.nih.gov/?term=Rosen+PH), [Roberto Bellucci](https://pubmed.ncbi.nlm.nih.gov/?term=Bellucci+R), [Sorcha Ní Dhubhghaill](https://pubmed.ncbi.nlm.nih.gov/?term=Dhubhghaill+SN), [Jos Kleijnen](https://pubmed.ncbi.nlm.nih.gov/?term=Kleijnen+J) ### Affiliation * 1 From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands (Wanten, Nuijts); Vienna Institute for Research in Ocular Surgery (VIROS), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Till, Findl); Service d'Ophtalmologie, CHRU Brest, Brest, France (Cochener-Lamard); Université de Bretagne Occidentale, Brest, France (Cochener-Lamard); Department of Ophthalmology, Goethe University, Frankfurt, Germany (Kohnen). * PMID: **42674864** * DOI: [ 10.1097/j.jcrs.0000000000002012 ](https://doi.org/10.1097/j.jcrs.0000000000002012) Item in Clipboard Practice Guideline # ESCRS guideline for cataract surgery 2024: executive summary Joukje C Wanten et al. J Cataract Refract Surg. 2026. Show details Display options Display options Format Abstract PubMed PMID J Cataract Refract Surg Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Cataract+Refract+Surg%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Cataract+Refract+Surg%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) . 2026 Sep 1;52(9):e1-e13. doi: 10.1097/j.jcrs.0000000000002012. ### Authors [Joukje C Wanten](https://pubmed.ncbi.nlm.nih.gov/?term=Wanten+JC&cauthor_id=42674864)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674864/#short-view-affiliation-1 "From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands \(Wanten, Nuijts\); Vienna Institute for Research in Ocular Surgery \(VIROS\), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria \(Till, Findl\); Service d'Ophtalmologie, CHRU Brest, Brest, France \(Cochener-Lamard\); Université de Bretagne Occidentale, Brest, France \(Cochener-Lamard\); Department of Ophthalmology, Goethe University, Frankfurt, Germany \(Kohnen\)."), [Victoria Till](https://pubmed.ncbi.nlm.nih.gov/?term=Till+V&cauthor_id=42674864), [Oliver Findl](https://pubmed.ncbi.nlm.nih.gov/?term=Findl+O&cauthor_id=42674864), [Béatrice Cochener-Lamard](https://pubmed.ncbi.nlm.nih.gov/?term=Cochener-Lamard+B&cauthor_id=42674864), [Thomas Kohnen](https://pubmed.ncbi.nlm.nih.gov/?term=Kohnen+T&cauthor_id=42674864), [Rudy M M A Nuijts](https://pubmed.ncbi.nlm.nih.gov/?term=Nuijts+RMMA&cauthor_id=42674864); [ESCRS Cataract Surgery Guidelines Working Group](https://pubmed.ncbi.nlm.nih.gov/?term=ESCRS+Cataract+Surgery+Guidelines+Working+Group%5BCorporate+Author%5D) ### Collaborators * **ESCRS Cataract Surgery Guidelines Working Group** : [Adi Abulafia](https://pubmed.ncbi.nlm.nih.gov/?term=Abulafia+A), [Anders Behndig](https://pubmed.ncbi.nlm.nih.gov/?term=Behndig+A), [Alexander C Day](https://pubmed.ncbi.nlm.nih.gov/?term=Day+AC), [Catarina R Pedrosa](https://pubmed.ncbi.nlm.nih.gov/?term=Pedrosa+CR), [Dominique Monnet](https://pubmed.ncbi.nlm.nih.gov/?term=Monnet+D), [Filomena J Ribeiro](https://pubmed.ncbi.nlm.nih.gov/?term=Ribeiro+FJ), [Gerd U Auffarth](https://pubmed.ncbi.nlm.nih.gov/?term=Auffarth+GU), [Jorge L Alió](https://pubmed.ncbi.nlm.nih.gov/?term=Ali%C3%B3+JL), [Kjell G Gundersen](https://pubmed.ncbi.nlm.nih.gov/?term=Gundersen+KG), [Mayank A Nanavaty](https://pubmed.ncbi.nlm.nih.gov/?term=Nanavaty+MA), [Nino Hirnschall](https://pubmed.ncbi.nlm.nih.gov/?term=Hirnschall+N), [Nic J Reus](https://pubmed.ncbi.nlm.nih.gov/?term=Reus+NJ), [Peter Hoffmann](https://pubmed.ncbi.nlm.nih.gov/?term=Hoffmann+P), [Paul H Rosen](https://pubmed.ncbi.nlm.nih.gov/?term=Rosen+PH), [Roberto Bellucci](https://pubmed.ncbi.nlm.nih.gov/?term=Bellucci+R), [Sorcha Ní Dhubhghaill](https://pubmed.ncbi.nlm.nih.gov/?term=Dhubhghaill+SN), [Jos Kleijnen](https://pubmed.ncbi.nlm.nih.gov/?term=Kleijnen+J) ### Affiliation * 1 From the University Eye Clinic Maastricht, Maastricht University Medical Center, Maastricht, the Netherlands (Wanten, Nuijts); Vienna Institute for Research in Ocular Surgery (VIROS), A Karl Landsteiner Institute, Hanusch Hospital, Vienna, Austria (Till, Findl); Service d'Ophtalmologie, CHRU Brest, Brest, France (Cochener-Lamard); Université de Bretagne Occidentale, Brest, France (Cochener-Lamard); Department of Ophthalmology, Goethe University, Frankfurt, Germany (Kohnen). * PMID: **42674864** * DOI: [ 10.1097/j.jcrs.0000000000002012 ](https://doi.org/10.1097/j.jcrs.0000000000002012) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## 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. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of ASCRS and ESCRS. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. Fang R, Yu YF, Li EJ, Lv NX, Liu ZC, Zhou HG, Song XD. Global, regional, national burden and gender disparity of cataract: findings from the global burden of disease study 2019. BMC Public Health. 2022;22(1):2068. doi:10.1186/s12889-022-14491-0 - [DOI](https://doi.org/10.1186/s12889-022-14491-0) 2. 1. Rossi T, Romano MR, Iannetta D, Romano V, Gualdi L, D'Agostino I, Ripandelli G. Cataract surgery practice patterns worldwide: a survey. BMJ Open Ophthalmol. 2021;6(1):e000464. doi:10.1136/bmjophth-2020-000464 - [DOI](https://doi.org/10.1136/bmjophth-2020-000464) 3. 1. Dans AL, Dans LF. Appraising a tool for guideline appraisal (the AGREE II instrument). J Clin Epidemiol. 2010;63(12):1281–1282. doi:10.1016/j.jclinepi.2010.06.005 - [DOI](https://doi.org/10.1016/j.jclinepi.2010.06.005) 4. 1. Whiting P, Savović J, Higgins JPT, Caldwell DM, Reeves BC, Shea B, Davies P, Kleijnen J, Churchill R; ROBIS group. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. J Clin Epidemiol. 2016;69:225–234. doi:10.1016/j.jclinepi.2015.06.005 - [DOI](https://doi.org/10.1016/j.jclinepi.2015.06.005) 5. 1. Neumann I, Pantoja T, Peñaloza B, Cifuentes L, Rada G. El sistema GRADE: un cambio en la forma de evaluar la calidad de la evidencia y la fuerza de recomendaciones. Rev Med Chil. 2014;142(5):630–635. doi:10.4067/S0034-98872014000500012 - [DOI](https://doi.org/10.4067/s0034-98872014000500012) Show all 29 references ## Publication types * Practice Guideline Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Practice+Guideline%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Practice+Guideline) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) ## MeSH terms * Cataract Extraction* / standards Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cataract+Extraction%2Fstandards%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cataract+Extraction) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) * Humans Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Humans%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Humans) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) * Intracameral Injection Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Intracameral+Injection%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Intracameral+Injection) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) * Lens Implantation, Intraocular Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Lens+Implantation%2C+Intraocular%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Lens+Implantation%2C+Intraocular) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) * Societies, Medical Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Societies%2C+Medical%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Societies%2C+Medical) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674864/) [x] Cite Copy Download .nbib .nbib Format: AMA APA MLA NLM **Send To** * [Clipboard](https://pubmed.ncbi.nlm.nih.gov/42674864/) * [Email](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674864%2F%23open-email-panel) * [Save](https://pubmed.ncbi.nlm.nih.gov/42674864/) * [My Bibliography](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674864%2F%23open-bibliography-panel) * [Collections](https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F42674864%2F%23open-collections-panel) * [Citation Manager](https://pubmed.ncbi.nlm.nih.gov/42674864/) [x] NCBI Literature Resources [MeSH](https://www.ncbi.nlm.nih.gov/mesh/) [PMC](https://www.ncbi.nlm.nih.gov/pmc/) [Bookshelf](https://www.ncbi.nlm.nih.gov/books) [Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 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