Older couple considering private cataract surgery

Private Cataract Surgery

Find out more about private cataract operation: the benefits, the removal procedure, artificial lens types and aftercare.

Private Refractive Cataract Surgery - What is it?

With basic cataract surgery provided by the NHS, you will usually be offered monofocal lenses, which have a single point of focus. This means the lens will be fixed for either near or distance vision, but not both.

Refractive Cataract Surgery is different to basic cataract surgery because the main reason for having the operation is to improve the vision without the need for glasses.

Such patients can generally see quite well with their glasses or contact lenses but find using them to be inconvenient or troublesome in day-to-day life, for hobbies and sports, and for work.

With Refractive Cataract Surgery, it is possible to provide good vision without glasses for distance and for reading, as well as for intermediate vision in many cases.

This can be achieved by using a variety of lens implant technologies that come under the broad categories of multifocal, trifocal, and extended depth of focus (EDOF) lenses.

Whatever technology is chosen, the objective is always to individualise the treatment and meet the objectives of the patient.

Refractive Cataracts Surgery - How does it work?

Surgery works by replacing the natural lens of the eye with a clear plastic lens.

A very small probe uses ultrasound to break the lens into very small segments and remove them from the eye.

There is a thin transparent membrane that surrounds the eye’s natural lens, and this is left in place to support the new lens implant. In this way, the new implant is located in the same place as the eye’s natural lens that was removed during surgery.

The lens implant has a strength of focus that is chosen to create a clear image on the retina and provide excellent vision after the surgery.

View the animation to learn more about how the surgery works.

Choosing your ideal lens

With Refractive Cataract Surgery the natural lens of the eye is removed. Without a replacement lens, the vision would be very poor indeed.

Therefore, inserting a new lens implant is what this surgery is all about. The type of lens implant you receive will determine the type of vision you have after your surgery.

Your vision goals

Once you’ve decided that you are going to have Refractive Cataract Surgery, the most important decision you will make is the type of lens implant you want to replace your natural lens with. This depends on how you feel about needing to use glasses for:

  • Near activities such as reading, using your mobile phone, seeing labels on packets and prices in shops, sewing and doing arts and crafts, and other close-up tasks
  • Intermediate distance activities such as using a computer, painting, reading sheet music, seeing a car dashboard, browsing labels in shops
  • Far distance vision

Finding the perfect fit

The most important step in choosing the correct strength in the lens is called biometry.

Biometry is the set of measurements that are taken before the surgery, usually at the first consultation. The measurements are used to calculate the power of the lens implant that will be used during the surgery.

Several aspects of biometry are crucial in optimising the accuracy of the lens choice and the visual outcome of surgery.

Prof Mohammed Muhtaseb takes biometry extremely seriously and uses the latest technology to take the most accurate measurements which are then entered into the calculation formulae that are shown to give the most accurate refractive outcomes that are closest to the pre-operative planned targets.

One of the most important, and sometimes under-estimated, issues in pre-operative planning is that of astigmatism.

Once the biometry measurements have been taken, Prof Muhtaseb looks specifically for any pre-existing astigmatism and determines if a toric lens implant should be used to minimise post-operative astigmatism. Indeed, if astigmatism is not specifically accounted for during the pre-operative planning phase, the surgery itself can lead to a greater degree of astigmatism post-operatively and the need to use glasses at all times to achieve clear vision.

The lens range

The main types of lens implant are described below:

  • Monofocal IOL – Providing a single point of focus the distance vision is usually good but glasses are needed for intermediate and near
  • Enhanced monofocal IOL – Provides good distance vision with a functional level of intermediate vision (e.g. for using the computer); glasses are required for seeing smaller fonts on the computer and for reading up close
  • Multifocal / Trifocal IOL – Provides the greatest range of focus with good vision at distance, intermediate, and near.
  • Toric IOLIf you have astigmatism a toric version of the above IOL types may be recommended to achieve the best vision after your surgery. Almost all IOL types are available with a toric correction for astigmatism, and so patients that have astigmatism should be able to choose from the full range of IOL types.

Patients may choose a standard monofocal IOL if they are happy to wear glasses for intermediate and near activities.

However, many patients elect for a more advanced, or premium, trifocal IOL if they like the prospect of seeing in the distance clearly and then being able to read, look at an iPad, and use a computer without needing to look for their glasses.

Refractive Cataract Surgery - Results

The results of Refractive Cataract Surgery are remarkably good, with very high patient satisfaction and extremely low complication rates.

Cataract surgery is one of the most successful and life-enhancing interventions in modern medicine, with a fast recovery and significant improvement of quality of life. The additional satisfaction that then comes with multifocal lenses is particularly high, as patients are able to see far away and read without glasses for the first time in many years or, in some cases, for the first time in a lifetime.

Patients often describe how their vision is much clearer, and colours much brighter after cataract surgery.

In addition, patients often report not realising “how bad the vision had become”, because cataracts develop so slowly and it’s only after the surgery had been done that they notice the great improvement in vision that allows them to lead a normal and active life once again.

Patients are especially pleased with the choice of outcomes that is offered by the variety of lens implants Prof Muhtaseb is able to make available to his patients.

Each patient’s lifestyle, hobbies and requirements are considered very carefully and a management plan is agreed with the patient so they have the best chance of achieving their desired outcome.

Refractive Cataract Surgery - Steps

Arrival at the surgery centre and welcomed by friendly reception staff.

Admission and initial checks by the nurse, who will also dilate the pupil of the eye to be treated.

Prof Muhtaseb will spend some time with you to allow any further questions and to sign the consent forms.

If a toric lens is to be used Prof Muhtaseb will carry out a further examination of the eye in preparation for surgery and to optimise alignment of the toric lens

The eye will be numbed by using local anaesthetic. This does not hurt. The anaesthetic is given by a very experienced and skilled anaesthetist who will ensure that you are comfortable and relaxed throughout the procedure.

Prof Muhtaseb will carry out the cataract removal and lens implant procedure. A transparent plastic shield is placed over the eye at the end of the operation for protection.

You will be taken to the recovery area where you will be offered a drink and something to eat, and any companion you have with you will be brought in to see you.

The nurse will provide your post-operative eye drops, instruct you how to instill them, and provide information on what you can and cannot do in the immediate recovery period. You will also be given an instruction sheet that summarises this information. You will also be given a phone number to call if you have any concerns.

Frequently Asked Questions

When is the right time to have a cataract removed?

A cataract does not need to be “ripe” or “ready” for surgery, as some people may think.

Cataract surgery is appropriate for anyone that has symptoms of cataract, has discussed the benefits and risks of cataract removal with their surgeon, and feels that treatment is the right decision for them.

This decision is very individual as symptoms that are felt to be minor by one person may be extremely troublesome to another person. This is the reason that a detailed discussion with an experienced surgeon is an essential step in deciding whether or not to proceed with surgery.

What are the differences between refractive cataract surgery and laser refractive surgery

Most people having Refractive Cataract Surgery will have considered laser refractive surgery as an option and been told that it will not provide good vision for distance, middle and reading; or they may be above the age of 50 years and have decided that Refractive Cataract Surgery is a better option because it is a one-off treatment since a cataract cannot develop later in life.

With laser refractive surgery it is inevitable that a cataract will develop at some point in time and then a further procedure will be required to remove it.

Are there options and alternatives to refractive cataract surgery?

Prof Muhtaseb will discuss all treatment options with you, including the options that he feels are not suitable.

This is because he feels you ought to know what is available and have all the information needed to make an informed choice.

Prof Muhtaseb will explain why he believes certain options are appropriate while others may be less optimal, and always allows time for plenty of questions until you are satisfied with the final plan of management.

Are there risks to refractive cataract surgery?

Refractive Cataract Surgery is very successful. However, no medical intervention carries a guarantee of perfection and all operations carry an element of risk.

The risks with Refractive Cataract Surgery are very low and most of the issues that can arise are amenable to treatment.

The risk of serious adverse events is very small indeed and this type of surgery remains one of the most successful surgical interventions.

The risks will be discussed with you in detail at your consultation with Prof Muhtaseb.

How long does cataract surgery take?

Cataract surgery is a fast, safe and painless procedure. It typically takes 10-15 minutes per eye. Because the most important thing is to complete the surgery safely, more complex cases can take a little longer than this. The recovery is usually very fast, with most patients noticing a great improvement in vision either on the day of surgery or within the first 2-3 days thereafter. 

How is a cataract operation performed?

Cataract surgery is performed through 2-3 very small self-sealing openings at the side of the cornea. Then a round opening is made in the transparent skin that envelops the cataract, which allows access to the cataract. The cataract is broken into tiny pieces using a process called phakoemulsficiation, and these tiny pieces are removed from the eye by micro-suction. The rest of the transparent skin remains in place and supports the new lens which is implanted through the openings that were made at the start of the operation.

How long does vision stay blurry after cataract surgery?

Recovery is usually very fast, with most patients noticing a great improvement in vision either on the day of surgery or within the first 2-3 days thereafter. The vision can be blurred for 2-3 days or longer if there is more inflammation or swelling than usual. This can be the case for dense cataracts, small eyes with less space than usual, or when the cornea is predisposed to swelling.

Are you awake during cataract surgery?

Yes. The vast majority of cataract surgeries are performed under local anaesthetic with the patient awake. However, the procedure is painless and you will not see or feel anything surgical. You only feel the surgeon’s fingers resting on your forehead, and you may feel cool water on or around the eye.

Can I have both cataracts done at the same time?

It is possible to have both eyes treated on the same day, but this varies from one hospital to another. Not all patients are suitable for same day bilateral cataract surgery and there are certain exclusion criteria that apply.

How long do I need time off after the surgery?

This varies depending on your job, any physical exertion, the risk of getting dirt in your eye, and other factors. For office based work you can expect to be able to return to work within a few days. Work that involves heavy physical activity or risks getting dirt or dust in the eye should be avoided for 2-4 weeks.

Discover the number one oversight patients make when choosing cataract surgery

Most people have cataract surgery without knowing about all the options they actually have surrounding cataract surgery. Unfortunately, most people only find this out after having cataract surgery. The information in this Wales Cataract Guide could save you frustration and worry. Simply click the button below to give us your email and we’ll send you this life changing guide:

Download our Cataract Guide

Is refractive surgery for you?

You’re over 45 and would love to read again without glasses

Unfortunately, reading glasses or varifocals get in the way of many of the things you most enjoy. Yes, spectacles help, but they are annoying little appendages that you lose or must clean to see clearly.

Book a consultation

Your vision is yellowing, duller, and cataracts are forming.

The effect on your life can vary from being slightly frustrating, through to significantly affecting your ability to function independently, or even causing a devastating reduction in vision.

Book a consultation

Benefits of getting Refractive Cataract Surgery in Wales

Revive your eyes

Not only have we removed your cataracts, but we’ve also fixed your reading and distance vision at the same time. You’re now experiencing optimum life-changing vision without visual aids.

RLE Wales, refractive lens surgery Wales

Confident and content

You’re so much more relaxed and content now that you’re not limited by reading glasses or varifocal spectacles. Your eyes are no longer letting you down, and you’ve got your confidence and independence back.

Cataract surgery Wales, Refractive lens exchange Wales

Expand your life

That awful cataract cloud has lifted, and the world is brighter and more colourful than ever. Throwing yourself into old and new hobbies is a real delight.

A new life in technicolour

You’ve worked hard to get where you are today, and now, with your renewed vision, you can really start to appreciate it. This is your time to do what makes you happy.

Hear from our patients

With over 6300+ surgeries performed hear from just a few of my happy patients.

It’s been incredibly liberating to wake up in the morning and be able to see without reaching for my glasses.

Cataract Surgery

I can go any anywhere and see anything near and far. I can see now as well as I could when I was 18 years of age which is incredible and I’m looking forward to clear vision for the rest of my life.

Kevin Taylor
Cataract Surgery

“No. 1 – My advice would be do it. No. 2 – See Mohammed if you can. I made the decision to not go down the NHS route because I wanted to see the best consultant – probably in the UK… It was absolutely worth it… because you can’t really put a price on your sight.”

Martin Harris
Cataract Surgery & Keratoconus Treatment
Martin Power
Refractive Cataract Surgery with multifocal toric lenses

“I can’t speak highly enough of (Prof Muhtaseb). Nothing was too much trouble, you could phone anytime, day or night. I wish I had done it when I first started wearing reading glasses and just gone to Prof Muhtaseb then and got it done. I would do it all over again, but do it much faster.”

Ann Edworthy
Refractive Cataract Surgery & Piggyback Lenses

“I would definitely recommend the professor. I think his approach is perfect! If you have any anxieties at all – just check with someone who’s had the procedure done. I had no pain at all. I expected a little bit of discomfort – but no pain, that was good. It’s life-enhancing and that’s not something you can put clearly enough. I didn’t realise how green the trees were! It’s lovely!”

Sue Sargeant
Cataract Surgery with a Duet multifocal lens

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About the expert

Prof Mohammed Muhtaseb, FRCOphth

Consultant Cornea, Cataract and Refractive Surgeon

iLase is the private practice of Consultant Ophthalmic Surgeon, Prof Mohammed Muhtaseb. Based in South Wales, he is one of the very few ophthalmologists working in the UK who is a fellowship-trained specialist in Cornea, Cataract and Refractive Surgery. He holds full specialist registration with the General Medical Council and was appointed as a Consultant in the NHS in 2006.

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