Key Takeaways

• EUREQUO recorded 363,039 cataract surgeries across 12 European countries in 2024, adding to nearly 5 million procedures captured since the registry was established
• Visual and refractive outcomes were strong, with postoperative BCVA of at least 0.5 achieved in 92.6% of eyes and 84.95% of eyes finishing within 1.0 D of the refractive targe
• Complication rates remained low, while ESCRS leaders identified broader registry participation and access to advanced IOL technologies as areas for continued development

Cataract surgery outcomes across Europe continued to show strong safety, visual, and refractive results in 2024, according to the latest data from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).¹

Data presented at the 44th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) included 363,039 cataract procedures performed across 12 European countries in 2024. Since its establishment in 2007, EUREQUO has recorded nearly 5 million cataract surgeries.

“Overall, the results are excellent across Europe,” said Carlo Bellucci, MD, a research fellow at the University of Parma in Italy. “However, because such a huge number of procedures are performed every year, even small improvements can make a meaningful difference for thousands of patients.”

Dr. Bellucci said the registry enables surgeons and clinics to benchmark their results and identify opportunities to improve outcomes.

Visual Outcomes Improve After Surgery

EUREQUO collects information including patient demographics, preoperative visual acuity, ocular comorbidities, surgical techniques, IOL selection, biometry, complications, and postoperative refractive outcomes.

Follow-up information was available for 54% of patients in the registry. Dr. Bellucci characterized the available follow-up population as an “exceptionally large and robust dataset.”

Best-corrected visual acuity (BCVA), measured using decimal notation, increased from an average of 0.448 before surgery to 0.939 after surgery. Postoperatively, 92.6% of eyes achieved BCVA of at least 0.5, while 68.6% achieved BCVA of at least 1.0.

Refractive results also showed relatively close agreement between predicted and achieved outcomes. The mean absolute biometry prediction error was 0.56 D, with 84.95% of eyes finishing within 1.0 D of the intended target.

“The annual EUREQUO report, produced by the ESCRS Registries Committee, demonstrates consistent progressive improvement in cataract surgery outcomes over the years,” Dr. Bellucci said.

Complication Rates Remain Low

Phacoemulsification with posterior IOL implantation remained overwhelmingly the most common surgical approach, accounting for 98.9% of procedures recorded in 2024.

Posterior capsule rupture was the most frequently reported intraoperative complication, occurring in 0.39% of procedures. The complication can allow vitreous to enter the anterior chamber and can create challenges for IOL placement.

Postoperatively, cystoid macular edema was the most commonly recorded complication, occurring in 0.13% of eyes.

Among advanced IOL technologies, toric lenses—which are designed to correct astigmatism—were the most frequently used. Monofocal IOLs, which generally provide clear vision at a single focal distance, remain commonly used.

Dr. Bellucci said further advances in IOL technology could expand options for patients seeking greater spectacle independence.

“Over the next few years, I expect that we will see an evolution in IOL technology with the development of simultaneous vision IOLs that have the goal of restoring vision at all distances, while minimising or eliminating the need for spectacles,” he said. “At present, their adoption is still limited by cost and technical research is progressing.”

The cost of advanced IOL technology remains one potential barrier to broader adoption. According to information accompanying the registry report, private cataract procedures can start at approximately £3,400 per eye in the United Kingdom and €4,000 per eye in the European Union, with final costs varying according to the IOL technology selected.

Registry Participation Remains a Priority

The scope of EUREQUO data varies by country. Sweden and the Netherlands maintain national cataract registries, enabling data from all participating clinics to feed into EUREQUO. Clinics in other European countries contribute data voluntarily, meaning the registry does not capture every cataract procedure performed across the participating countries.

Burkhard Dick, MD, PhD, ESCRS president and chair of the Department of Ophthalmology at University Eye Hospital Bochum in Germany, said continued surveillance is important for assessing the safety, effectiveness, and quality of cataract and refractive surgery.

“As demonstrated by the most recent report, outcomes in Europe are outstanding, with very low complication rates and improved visual and refractive results,” said Dr. Dick, who was not involved in the research.

He also highlighted participation as an area for improvement.

“The registry is only as good as the data we provide, and greater participation by European ophthalmologists in the EUREQUO study is necessary,” Dr. Dick said. “This will allow us to compare results and identify ways to improve. We are also hoping for greater availability of advanced lenses in the future.”

Reference

1. Abstract FP25.13, ‘ESCRS EUREQUO Cataract Registry: 2024 Annual Report’, by Carlo Bellucci et al, ‘Service delivery: training and AI in cataract care’ session, 08.30-10.00 hrs BST, Tuesday 15 September, https://pagv3.virtual-meeting.org/escrs/escrs2026/en-GB/pag/presentation/575332?guestPreview=1&q=FP25.13&view=list&segment=presentations&sort=starts_at.