Advances in cataract surgery: is a new era on the horizon?

To summarize recent technological, procedural and material advances that are reshaping cataract surgery and to appraise their implications for visual outcomes, safety and global accessibility.

Phacoemulsification remains the gold-standard technique, yet refinements in fluidics, ultrasound modulation and heads-up 3-D visualization continue to enhance efficiency and surgeon ergonomics. Femtosecond laser assistance yields measurable benefits in dense or unstable lenses but offers comparable long-term vision to modern phaco in routine cases. Presbyopia-correcting optics have diversified: trifocal and extended-depth-of-focus lenses deliver high rates of spectacle independence, light-adjustable lenses permit postoperative power customization, and early fluid-based or dual-optic accommodative models show 2-2.5 D of true accommodation. Intraoperative tool, digital overlays, aberrometry, microscope-integrated optical coherence tomography, and artificial intelligence-driven video analytics increase refractive precision and aid training. Drug-eluting and nanopatterned intraocular lenses, portable low-cost equipment and sustainability initiatives address comorbidity management, access and environmental impact.

Cataract surgery is evolving into a comprehensive, personalized ocular-rehabilitation procedure that corrects refractive error, treats coexisting disease and maximizes visual quality. Parallel efforts to expand workforce capacity, reduce costs and minimize waste are essential to ensure these innovations benefit patients worldwide.