Advanced Cataract Surgery

Achieving these outcomes takes a great deal of additional pre-operative examination and requires the expertise of a specialist anterior segment ophthalmic surgeon.

An anterior segment surgeon specialises in surgery to the cornea and lens exclusively. At Custom Vision Clinics, the surgeon measures the astigmatism and spherical aberration of the cornea and uses this information to precisely calculate the lens power required at the time of cataract surgery and the additional reshaping of the cornea required to provide the best possible outcome for each patient.

Understanding your private and NHS cataract surgery options

At Custom Vision Clinic the only questions we are ever asking about our cataract surgery are, “How do we improve the patient experience?” and “How do we improve our patient outcomes?”

In the NHS, the funding restrictions mean that the most commonly asked questions in cataract surgery care are “How can we push more patients through an operating list?” and “How can we make the operation cheaper?”

These differences in approach drive different outcomes:

Advantages of premium cataract surgery over conventional cataract surgery (on the NHS)

With premium cataract surgery:

• You choose your surgeon.
• Your surgeon plans your treatment with you after discussing your lifestyle, eye health and ambitions for your vision.
• Your surgeon oversees your entire patient journey and if you have any concerns you can simply call their personal mobile number.
• Most NHS cataract operating lists are put together from pooled lists of patients and the first time the patient meets their surgeon is on the day of surgery.
• You choose when you want your surgery done.
• You can have both eyes treated within one week.
• Many NHS units make patients wait months to have their second eye treated.
• You can have cataract surgery before it significantly impacts your vision and lifestyle.
• In many areas of the UK the NHS apply thresholds to when patients can receive treatment. The patient may have to wait until their vision is very poor before they are offered treatment.
• Additional measurements are taken before treatment planning to improve safety and accuracy. At Custom Vision Clinic all patients have IOLmaster 700 biometry, Lenstar biometry, Pentacam corneal shape measurement and an OCT scan (retinal scan).
• In most NHS units and also many private hospitals, patients only have one set of measurements on one biometry machine.
• You attend at a specified surgical appointment time so that you are not waiting with other patients
• Adaptive fluidics are used during the cataract surgery. This makes the surgery more comfortable and safer. The adaptive fluidics reduce the risk of surgical complications and reduce the risk of damage to the optic nerve.
• Adaptive fluidics are more expensive and so rarely used in NHS units and are only used in some private clinics.
• Toric astigmatism correcting lenses are used for all cases where the lens will provide clinical benefit.
• In most NHS units, astigmatism is left untreated at the time of cataract surgery and in almost all private clinics are only provided at additional cost.
• Only hydrophobic acrylic lenses are used at Custom Vision Clinic.
• Many NHS units use hydrophilic acrylic which are much less expensive than hydrophobic lenses but which cause a high rate of secondary cataract -PCO.
• If PCO occurs within two years of surgery then corrective treatment (YAG capsulotomy) is provided free of charge.
• The majority of private clinics make an additional charge for a YAG capsulotomy. We do not.
• Additional medications are provided to ensure the best possible post-operative recovery.
• If the refractive outcome (need for spectacles) is not what was planned despite all the extra measurements at Custom Vision Clinic we offer enhancement surgery free of charge (LASIK, LASEK or piggyback lens implantation – note: this is a clinical decision made between surgeon and patient after weighing up the pros and cons of further surgery – even with further surgery it is not possible to guarantee a specific refractive outcome or level of spectacle independence).
• The majority of NHS patients require spectacles for distance and/or near vision after cataract surgery. The majority of private clinics either do not have the facilities for enhancement treatment or, if they do, make an additional charge for this service. We provide enhancement surgery free of charge.

What questions should you ask your cataract surgeon?