The event was a record-setting four days of colour, conga lines and sometimes comedy. But beyond the costumes there was some serious learning going on. Insight offers a flavour of this often crazy conference.
AUSCRS 2025 began with an ending.
But in the four days that followed, there was enough evidence that not only did the event have an exciting future as Australia’s premier gathering for cataract and refractive surgeons, the sector itself was ready for an exciting future of innovation in technique and technology – much of which was on display in the trade exhibits surrounding the main stage and arena.
That ending was the announcement that Australian Society of Cataract and Refractive Surgeons (AUSCRS) co-president Professor Gerard Sutton would be stepping down after three years at the helm with Dr Jacqueline Beltz.
After entertainment from Gamilaraay man Mitch Tambo and his wife LeLe, and a video promoting host city Darwin and the Northern Territory, Prof Sutton and Dr Beltz entered the opening evening dressed as fair-dinkum Aussie tour guides.
Driving a battered 4WD to the main stage.
Crikey. Strewth. AUSCRS was up and running in typical style.
Three years ago, the pair took over the co-presidency roles from Professor Graham Barrett and Dr Rick Wolfe, who founded AUSCRS in the mid-1990s. Dr Beltz will now be the society’s president, with Dr Andrea Ang, a consultant ophthalmologist at Lions Eye Institute in Western Australia, named as vice-president.
“It’s been an absolute ride,” Dr Beltz told the audience of nearly 220 eye surgeons, advanced trainees and support staff about her time with Prof Sutton.
“We’ve shared so many memorable moments up here on stage, but it’s behind the scenes, plotting, planning, laughing that I treasure the most.
“We’re going to say thank you a few times throughout this meeting, but I want to take every chance I can to say it again now.
“So Gerard, it’s been a blast. Thank you very much.”
That ending suitably acknowledged, the event, famous in global ophthalmology circles for its relaxed staging, themes and costumes, kicked off with the Barrett/Wolfe lecture delivered by Professor Michael Knorz, medical director of the FreeVis LASIK Center Mannheim and internationally recognised as one of the leading experts in the field of refractive and cataract surgery.
He talked about the past and present of presbyopia-correcting intraocular lenses. But it was his views about the future that would have gained most attention.
Prof Knorz has been involved in trials and analysis of a number of IOLs and told those assembled that he was particularly impressed at the technology and rise of extended depth of focus (EDOF) IOLs.
“Patients can expect excellent distance vision and quick intermediate vision,” he said.
“They can expect few side effects at night.”
Although, he conceded that it was more likely that patients would need glasses for reading or other near-focus tasks.
Mulifocals also allowed for good distance and intermediate vision, with patients less likely to need glasses at all.
“But optical side effects [glare, halos, especially at night] are much lower, much less in EDOF IOLs,” he said, “whereas multifocal IOLs have significant side effects.”
He liked to take his time with patients, explaining the compromises they would have with different IOLs.
“Patients will make this choice, and it’s really important to let them know that there is a price, but undersell and over-deliver.”
He highlighted the rise of new technology to help eye surgeons do that, including an Austrian simulator that let ophthalmologists and patients experience what their vision would be like using various lenses.
Prof Knorz believes that EDOFs will become the standard of care in surgery, certainly in comparison with monofocals.
“Their benefits far outweigh the small side effects.”
The future, he says, is about “adjustability”, whether that is development of the light adjustable lens that could be altered post-surgery or accommodating lenses that worked more with the eye’s muscles.
Another innovation to watch was a lens that relied on contraction of the ciliary muscle to alter the shape of the lens for “absolute accommodation”.
“I believe that the future will be some accommodating design.”
The future was very much on the minds of other presenters at AUSCRS.
Whether they wore mediaeval costumes for a Game of Thrones-themed exploration of challenging cases, or donned hoverboards for the Back to the Future-foray into cataract surgical outcomes, the discussion was always forward focused.
Leading ophthalmic experts, including Dr David Lockington, consultant ophthalmologist at Tennent Institute of Ophthalmology, in Glasgow, and Dr Matthew Rauen, a board-certified and fellowship-trained cornea and refractive surgery specialist in the US, talked about some of their most difficult and stressful surgical cases, including sometimes confronting videos.
They then faced up to often challenging discussion and inquiry about what they might have done or considered if they had the chance again.
It was not quite the Red Wedding (a pivotal and shocking massacre in the Game of Thrones), but upcoming presenters would have been aware that Winter was coming and the White Walkers were not going to take any prisoners.
It was the same as Dr Rauen again stood up, this time dressed as Dr Emmett Brown from Back to the Future, white hair suitably shocked and upstanding for the electrically charged topic of interoperative intraocular pressures in cataract surgery.
He promoted the use of lower pressures during surgery to help keep the surgical environment more stable.
Using video and other resources, he demonstrated that introducing a phaco probe with an infusion pressure of 65 mmHg could make the patient uncomfortable and the eye unnecessarily tense and hyperinflated. “But watch when we drop the infusion pressure to 28 mmHg – we see relaxation of the intraocular tissues and a return to a more natural anatomic state.
“It just shows us when we operate at higher infusion pressures, we are distorting the ocular anatomy,” he told the audience. “There are many groups throughout the world looking at this.”
There is also less leakage from incisions when surgery is performed using lower infusion pressures. This leads to less unnecessary fluid travelling through the eye during routine cases.
“So the question is, with modern technology and advanced fluidic systems, why would we use such high infusion pressures?” Dr Rauen asked.
“When it comes to corneal endothelial cell loss and intraoperative patient comfort, there is a growing body of evidence showing benefits of lower infusion pressures.”
“Where we are going . . . we don’t need a high pressure.”
But it was not just the speakers putting out those questions over the three days of presentations for surgeons and their support staff. There were plenty in return that pushed many to the edge of their comfort zones and often beyond.
That was evident in numerous other sessions, including those looking at head-to-head comparisons of different IOLs, the future of lenses and cataract and refractive surgery, the use of AI in surgical education, and Controversy Corner, the “masked debate” on “hard calls and hot takes” in ophthalmology.
That sometimes uncomfortable challenge to push and improve, albeit delivered by a person possibly in plastic chain mail and holding a fake sword, is what makes AUSCRS the premier industry event in Asia-Pacific, says Prof Sutton.
“AUSCRS 2025 was another successful conference,” he says.
“Apart from the usual local ophthalmologists contributing with knowledge and passion, I think the international speakers were particularly strong this year.
“In particular, I enjoyed the lectures from Dr Cathleen McCabe and Dr Sri Ganesh.”
He believes he is leaving the role of co-president with AUSCRS in a healthy position. He will remain on its committee.
“It was always going to be a tough task taking over from Graham Barett and Rick Wolfe after 25 years.”
COVID had been challenging and put financial pressure on AUSCRS.
“We were determined to ensure that that was addressed and AUSCRS is now in its strongest financial position ever for further growth and we have increased the number of sponsors.”
The 2025 event featured a record six gold and 20 silver sponsors, on top of five platinum sponsors.
There were 150 company representatives as well in the many exhibits and booths that ringed the main stage and arena.
And far from being put off by the sometimes challenging debate and discussion, there was a “continual stream of the best international experts in ophthalmology pleading to be invited each year”, says Prof Sutton.
He thanked Dr Beltz, executive officer Ms Jenny Boden and others at AUSCRS for their support, as well as former co-president Prof Barrett and Associate Professor Michael Lawless, “who will always be my role model of the professional surgeon”.
Dr Beltz said feedback had been “overwhelmingly positive, with many calling it the best AUSCRS meeting they’ve ever attended, even while recovering from middle-of-the-night flights home from Darwin”.
She said the opening ceremony featuring Tambo and his wife LeLe, who performed You’re the Voice in both Gamilaraay and English, was “an unforgettable, emotional moment that left me with tears in my eyes, even during rehearsal”.
The drive into the arena took her back to her youth, “the 4WD reminiscent of the one I learned to drive in during the ‘90s”.
But it was thoughts of the future that had her most excited.
AUSCRS 2025 had featured “engaging, thought-provoking discussions throughout the program, from topics like When is a cataract not a cataract? to forward-thinking sessions on IOL choices, education strategies, and laser technologies”.
There was record support from sponsors, and strong, ongoing engagement from delegates, “showing the continued momentum and relevance of AUSCRS”.
“As Gerard steps down and Andrea Ang steps into a leadership role, I’m incredibly excited about the future of AUSCRS and the growing AUSCRS family,” Dr Beltz said. “Some people are already trying to book their accommodation for Sunshine Coast 2026!”
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