ESCRS - FP09.15 - Mapping The Preoperative Refractive Profile Of European Cataract Surgery: A Three-Year Real-World Study Of >180,000 Patients

Mapping The Preoperative Refractive Profile Of European Cataract Surgery: A Three-Year Real-World Study Of >180,000 Patients

Published 2026 - 44th Congress of the ESCRS

Reference: FP09.15 | Type: Free paper | DOI: 10.82333/xdtb-sd34

Authors: Mr Alexander Silvester* 1 , Mr Felipe Dhawahir Scala 1 , Mr José Luis Güell 2 , Mrs Elena Arrondo 2 , A/Prof. Ulrich Kellner 3 , Mrs Ioana-Sandra Tarau 4 , Dr Irene Siso-Fuertes 5

1SpaMedica,Manchester,United Kingdom;veonet,Munich,Germany, 2Grupo Miranza,Barcelona,Spain;veonet,Munich,Germany, 3Ober Scharrer Group,Siegburg,Germany;veonet,Munich,Germany, 4Ober Scharrer Group,Baden-Baden,Germany;veonet,Munich,Germany, 5veonet,Munich,Germany

Purpose

To describe and characterize the preoperative refractive profile of patients undergoing cataract surgery within a large European eye care group, analysing preoperative sphere (sph), cylinder (cyl), axis and preoperative spherical equivalent (SEQ) and the age-related differences and temporal trends.

Setting

Grupo Miranza (Spain), SpaMedica (United Kingdom), OSG (Germany)– all part of the veonet Group.

Methods

A retrospective multicenter real-world study using veonetVerse, Veonet’s centralized clinical data repository was conducted, including consecutive cataract surgeries (2023–2025). One eye per patient was analyzed; outliers excluded(z-score=4). Collected variables: age, gender, preoperative sph, cyl, axis, SEQ, and implanted IOL power. Sph categories were grouped into: high (≤−6), moderate (−6,−3] and low (−3,−0.50] myopia; emmetropia(−0.50,+0.50); low (+0.75,+2], moderate (+2,+5] and high hyperopia ≥+5.25D. Cyl was grouped into: low(0.25–1.5), moderate(1.5–3), high(>3). Comparisons used ANOVA, χ² tests (significance p<0.05) and risk ratios; linear regression assessed sphere–IOL power association. Data was stratified by age, year and IOL type

Results

188,295 were eyes analyzed. Hyperopia prevailed (52%), followed by myopia (34%) and emmetropia (14%). SEQ clustered centrally: 24% between +0.50 and +2D; 81% between −2 and +3.50D. High myopia and high hyperopia represented 8%. Sph correlated inversely with IOL power (slope=0.8). Refractive distribution varied by age (p<0.001). Patients ≥80y were twice as likely hyperopic and half as likely myopic vs 40–49y, who were 9x more likely high myopic. Low, moderate and high astigmatism occurred in 60%, 30% and 3%. No differences found across years or countries despite healthcare delivery models (Cramér’s V=0.01–0.04). IOL choice weakly linked to refraction; ≥80y patients favoured Partial-RoF Enhanced and were less likely to receive Full-RoF IOLs

Conclusions

In this large European cohort, hyperopia predominated. Nearly 1 in 13 eyes showed extreme refractive profiles (4% high myopia, 4% high hyperopia). Hyperopia increased and myopia decreased with age. Moderate-to-high astigmatism was frequent (33%). These patterns suggest the need for optimized biometry, appropriate power and toric IOL inventory, astigmatism management strategies, and planning for complex eyes. Refractive profiles remained stable over time across the group, supporting data-driven capacity, inventory, and workforce planning. IOL choice showed limited association with refraction, indicating lens selection is influenced not only by age, but also by additional patient-related factors.