PROMs and Cataract Surgery: Measuring Value, Transforming Practice, and Building a National Registry

Cataract surgery is among the most commonly performed, safest, and most cost-effective procedures in modern medicine. However, surgical success can no longer be assessed solely through traditional clinical indicators such as visual acuity, refractive accuracy, complications, or costs. Patient-Reported Outcome Measures (PROMs) provide a structured way to incorporate the patient’s perspective by measuring the real functional impact of surgery on quality of life, independence, and daily activities. Based on the French experience reported in NEJM Catalyst, this presentation shows that PROMs are not merely descriptive tools: they can influence surgical indications, improve appropriateness of care, and support practice transformation. The example of immediate sequential bilateral cataract surgery, assessed in the BICAT-NL randomized trial published in The Lancet, further illustrates how PROMs can help evaluate surgical innovation by combining safety, effectiveness, cost-effectiveness, and patient-perceived benefit. Implementing a French national cataract registry incorporating PROMs would create a shared language of quality among patients, surgeons, hospitals, healthcare authorities, and payers.