Mr Nick A Jacobs FRCS FRCOphth

Anyone wishing to have a cataract extraction or a clear lens replacement procedure (refer to relevant section) has the difficult job of choosing a surgeon who is most likely to give a good outcome.

This is not as easy as it might seem as cataract surgeons vary quite markedly in their technical surgical skills. Often cataract surgery is portrayed in the media as something quick and straightforward. It is true that it may be done quickly in skilled hands, but it is certainly not straightforward and, is in fact, a difficult microsurgical procedure.

Some consultants carry out cataract surgery privately who do not do cataracts on their National Health lists due to their individual sub specialty being in a different field. Therefore, it is worth asking the question.

You are not necessarily looking for a surgeon who sells himself with the most attractive or comprehensive website or who has an unduly high opinion of themselves. You are not looking to make a best friend or to find someone who is over effusive with your family. You are really after an experienced surgeon with consistently good outcomes. I have extensive experience of high volume cataract surgery, such as, Initiatives for the National Health Service, as well as my regular National Health Service and private work. For example in 2008 I carried out almost 500 cataract operations for Kingston eye Hospital. Good outcomes are monitored by regular audits.

The question is, how do you find such a surgeon?

Who actually knows whether one surgeon gets a better outcome than another?

The recommendation of friends is very nice, but is not statistically meaningful.

Opticians and theatre staff have a limited local knowledge of relative abilities of surgeons, who themselves do not necessarily know about the abilities of other surgeons, and I would say the only people who really know are the surgical instrument and equipment representatives who visit operating theatres regularly in a wide area.

Therefore if one of the major surgical companies (such as AMO) recommends a particular surgeon as one of the physicians for the use of their lens implants or other equipment that gives you a good chance of getting one of the better surgeons to look after you.

See AMO website - Find a Doctor

My technique involves doing the actual phacoemulsification of the nucleus further forwards in the anterior chamber of the eye.

This article explains my technique: Surgeon: ‘Phaco out’ surgery with tools quicker procedure than in-the-bag phaco;

Ocular Surgery News Europe Edition, July 2012

Cataract, Clear Lens Extraction, Glaucoma