If you are thinking about having private cataract surgery how do you chose a private cataract surgeon? You may have received recommendations from your optometrist or GP or a friend, or you may have searched online to find excellent cataract surgeons in your area.
1. Does the cataract surgeon have an NHS contract?
The UK and NHS have one of the most rigorous training programmes for ophthalmic surgeons in the world. To obtain a consultant ophthalmic surgeon post in an NHS hospital takes years of subspecialty training, studying and multiple exams, so you can be reassured that the surgeon has received highly sought after Royal College approved training.
Competition for places in ophthalmology training is highly competitive, and if your cataract surgeon has obtained a consultant post in an NHS hospital, they will have worked incredibly hard to get this challenging & privileged post. They are also subject to annual appraisal and revalidation by the General Medical Council meaning that their clinical and surgical practice is evaluated annually to ensure they are “up to date & fit to practice.” This appraisal process should give you reassurance that this consultant practices to the high standards the NHS and Royal College demand.
Most consultants who offer private cataract surgery will tell you where their NHS contract is on their website or in the information portfolio. They will also tell you what their subspecialist skills are and this is incredibly important if you are a patient who has other eye problems and is seeking cataract surgery. For example, as I am a glaucoma specialist as well as a cataract specialist I can discuss how cataract surgery can help the pressure control in your eye meaning that we use the one operation to address both issues.
2.Does the surgeon’s website connect with you?
Most private cataract surgeons have a website that gives you information about them as a surgeon and information on the conditions they treat. This website is their ‘shop-front’, and they will have taken great care in preparing the information they put on their website. You can get an excellent feel for how the surgeon may be in person.
I wanted to make my website as patient-friendly as possible and give lots of information about the conditions I treat including cataracts. I passionately believe that patients should have access to high-quality information about their eye problems in a meaningful format that is easily accessible for them and their family and friends who will support them in the preoperative stage and aftercare following cataract surgery.
You can only make the right decision about your eye care if your cataract surgeon gives you correct and personalised information. Your friends may have had cataract surgery and been very happy, but you can’t be sure that their condition or situation is the same as yours. Cataract surgery is not a one size fits all operation, and the cataract surgeon’s website should reflect this.
On their website, you can also see the surgeon’s affiliations, e.g. one would expect a top private cataract surgeon in London to be a member of the Royal College of Ophthalmologists and other national & international societies of the subspecialties they treat. For example, I am a member of the Royal College of Ophthalmologists, the UK and European Cataract & Glaucoma Societies amongst other prestigious highly regarded professional groups.
Affiliations will also give you some information about any teaching and training they do. Excellent cataract surgeons are often very keen to pass on their skills and experience to eye surgeons in training.
Training other cataract surgeons is a significant part of my NHS job and one I am very proud of. I am frequently asked to give lectures and talks on the conditions I treat, both at home and internationally. My podium experience shows the level of peer support I enjoy and connect with meaning I am aware of the latest treatments and surgical techniques (both those that work well and those that probably don’t) giving you greater confidence that your treatment plan will reflect the proven research.
3. Where does the surgeon consult and operate?
Cataract surgery is the most common operation carried out in the UK and is highly successful in skilled hands.
As a patient, you will see your cataract surgeon at least once in the run-up to your operation and once or twice afterwards. You will also have a pre-operative assessment for the very detailed measurements required to choose your new lens implant. Most surgery is carried out under local anaesthesia. That means the patient can leave hospital 1-2 hours after the procedure has finished. Some patients prefer to have a general anaesthetic, and your surgeon should be operating in centres where you have both options.
In cases of general anaesthesia, your surgeon should have a good working relationship with the anaesthetist.
For example, I am very fortunate in working with several highly skilled anaesthetists who all have NHS contracts in London teaching hospitals and most of whom I work with in my NHS practice. The easy interaction between the surgical team and anaesthetist is critical to a successful outcome from surgery.
The logistics of attending and having relatives with you at each stage as required is something you should think about when booking your first appointment. I have operated on many patients who live locally in London but have also looked after lots who chose to travel from much further afield. These patients who travel further do so because they wish to have an excellent surgeon operate on their eyes in a centre of excellence such as Harley street or Imperial College Private Patients in my case.
An excellent cataract surgeon and their team will make the whole process as easy as possible from the initial appointment to discharge to ensure that they schedule all appointments at mutually convenient times.
An excellent cataract surgeon will also see you in person in the initial consultation and at the follow up ensuring you have personalised care and continuity throughout. This continuity is incredibly important to me, and you can be reassured as a patient that if you have questions before or after surgery, you will be dealing with the same doctor – me.
4. Quantity and quality
Numbers and statistics matter. All consultant eye surgeons with an NHS contract have their practice evaluated and benchmarked on a rolling annual basis- both NHS & private operations. A good private cataract surgeon will share this information with you; the number of cases they operate on and the complexity of these cases as well as the success rates of their surgery.
Remember that surgeons who operate in teaching hospitals face very challenging and difficult surgical cases and so are very experienced in dealing with more difficult cases but also in dealing with straightforward ones. If you are a patient who has more than one eye problem and need cataract surgery or you have only one good seeing eye that now needs surgery you should consider how experienced your surgeon is in dealing with more complex cases.
As a teaching hospital surgeon who has trained in Oxford, Moorfields and Imperial College my skills in dealing with complex cases are highly refined, continually evaluated and despite the complexity of my case mix I have higher than average success rates in cataract surgery. No operation is risk-free, and you should view any surgeon that promises you 100% success with scepticism.
Cataract surgery is highly successful, and any increased risk factors you may have that could potentially affect the success of your surgery should be openly discussed before you set a surgery date. An excellent private cataract surgeon will always do this.
5. Face to face first impressions
Ultimately nothing will tell you that you have made the right choice of surgeon until you meet them face to face.
A good result from any operation including cataract surgery needs a good working partnership between the surgeon and the patient. Mutual trust & respect must exist. It’s like viewing the house that you might buy or arriving at a hotel for your holiday, first impressions are critical.
All excellent cataract surgeons and their team will make you feel at ease. You should be encouraged to ask questions and should be directed to information to look at after the consultation just in case you forget some of the things discussed. You should never feel pressured into paying for surgery on the same day as a consultation, even if someone offers you a discount.
The decision to go ahead with surgery is an important one, and a good surgeon will want you to be delighted with your choice before booking the date. I do my utmost to make sure you have the right clinical information and support when scheduling your surgery. When you decide to go ahead, you should feel reassured that you have made the best decision for you and your loved ones as cataract surgery can transform your sight and quality of life!