What Are the Differences Between Private Cataract Surgery and NHS Cataract Surgery?

Pre-COVID, almost half a million cataract surgeries were performed per year on the NHS, making it one of the most commonly performed elective operations. Overall cataract surgery results are very good on the NHS and results data is regularly published.

There are a number of differences between NHS cataract surgery and private cataract surgery. In brief, cataract surgery on the NHS is to remove the cataract but not necessarily to correct the vision to reduce the need for glasses afterwards.

What are the choices for my vision after private cataract surgery compared to NHS?

Most NHS hospitals use only one type of intraocular lens implant due to cost restrictions, this being their standard monofocal lens such as the Alcon SN60WF. With a monofocal lens the lens power is usually chosen to give good distance vision without glasses after surgery, with glasses being needed for intermediate vision (computer work) and all near tasks such as reading. 

Privately there is a much larger range of intraocular lens available such as enhanced monofocal lens (which give excellent distance and clearer intermediate vision, and glasses are still needed for near), or enhanced depth of focus (EDOF)/ advanced multifocal lens which aim to give good distance, intermediate and some near vision; so greatly reducing spectacle dependence. 

At the same time any astigmatism is also corrected to result in the best possible vision after surgery without glasses. Astigmatism correcting lens (toric lens) are also available on the NHS, but these are usually only used for those patients with very high astigmatism (>2 diopters).

Who will do my surgery if I go privately compared to on the NHS?

If you choose to have your cataract surgery privately, you get to choose who your surgeon is, and only they will do your surgery. On the NHS most operating lists are pooled to help reduce NHS waiting times. This means you will often not meet your surgeon until the day of admission, or even just a few minutes before your cataract surgery. 

Private cataract surgery is performed by the Consultant of your choice, on the NHS, any trained surgeon will perform your operation. The NHS has a very important role in the training of future cataract surgeons and so surgeries are performed by Specialist Trainees or Fellows under the supervision of a NHS Consultant, if not by the NHS Consultant.

What are waiting list times like for private cataract surgery compared to NHS cataract surgery?

Waiting lists for private cataract surgery are typically just a few weeks, compared to a few months for NHS cataract surgery. Due to COVID-19, many NHS Trusts now have much longer waiting lists than previously.

Who will I see after my private cataract surgery for follow-up?

You will see Mr Alex Day at 2-3 weeks after your surgery for followup before you are discharged to your optician. This is to ensure the health of your eye and that all has healed well. 

It is also important as your final focus and vision will be measured which allows for continuous audit of Mr Alex Day’s outcomes to ensure the best possible care is being delivered. You will also be given Mr Alex Day’s emergency mobile number if you have any issues, meaning access to your surgeon 24 hours a day. 

On the NHS, most patients are now discharged to an Optometrist for followup, so they do not see their surgeon again unless there is some sort of complication. NHS cataract surgery patients need to attend A&E if they have any postoperative issues.

Other than lens choices, are there any other differences in surgical technology between NHS and private cataract surgery?

Mr Alex Day can offer femtosecond laser assisted cataract surgery (FLACS), and laser refinement for the best vision possible. Laser refinement is a second step if needed to ensuring you get the best vision possible after your surgery.