The European Society of Cataract and Refractive Surgeons Cataract Simulation Curriculum: Wet Lab and Virtual Reality Pathways to Competency

Cataract surgery training across Europe remains heterogeneous despite high procedural demand, and a harmonized simulation pathway is lacking. This Special Report proposes an ESCRS cataract simulation curriculum that national training bodies and educators can adapt to existing programmes. It synthesizes European training surveys, evidence on simulation-related performance and safety benefits, and European Society of Cataract and Refractive Surgery (ESCRS) educational infrastructure. The pathway comprises entry assessment, foundation skills, core phacoemulsification, complication management, supervised operating-room progression, and maintenance of competency. Progression is based on objective virtual reality (VR) metrics or structured wet-lab scoring combined with workplace-based assessments. Model-eye and VR modalities are mapped to complementary stages of training, and implementation is framed around national portfolio integration, regional hubs, the ESCRS Moving Simulator, sustainability metrics, and equity monitoring. A standardized but locally adaptable curriculum may improve readiness for live surgery, support maintenance of competency, and promote safer, more equitable cataract training.