ESCRS 2025: Cataract Surgery Practice Styles

Biomarkers of Pain and Inflammation During Second Eye Cataract Surgery Under Topical Anesthesia-Pilot Study

Presenter: Lucia Ibares Frias

A prospective cohort study involving 11 patients undergoing consecutive bilateral cataract surgery investigated changes in pain, inflammation biomarkers, and clinical parameters. Despite lower preoperative anxiety (measured by State Trait Anxiety Inventory, STAI), 63.6% found the second-eye surgery more painful. 

The second eye showed higher preoperative tear Fractalkine and chemokine CCL2 (MCP1) levels at all-time points (p<0.05), and reduced nerve growth factor (NGF) in aqueous humor (p<0.05), with no differences in other cytokines or clinical factors. These results suggest heightened inflammatory chemokine responses and lower NGF may contribute to increased pain during second-eye cataract surgery, even when anxiety is reduced.

Safety and Efficacy of Intracameral Steroids in Controlling Post-Operative Inflammation in Phacoemulsification: A Meta-Analysis

Presenter: Lorenz Jacob Mangahas

A meta-analysis following PRISMA guidelines compared intracameral steroid injections with traditional topical corticosteroids for controlling postoperative inflammation after cataract surgery. Four randomized controlled trials were included. 

Results showed no significant differences between groups in reducing anterior chamber cells (MD = -0.11, p=0.07), flare (MD = 0.04, p=0.29), or intraocular pressure (MD = -0.06, p=0.81). Adverse events were minimal, with one serious event reported in the intracameral group. The findings support intracameral steroids as a safe, effective alternative to topical steroids, potentially improving compliance due to easier administration without compromising safety or efficacy.

European Society of Cataract and Refractive Surgeons (ESCRS) Congress 2025, September 12-16, Denmark