LP: Refractive cataract surgery2020-05-01T05:05:00+00:00

Refractive Cataract Surgery

Seize the once-in-a-lifetime opportunity to remove your cataract and become free of glasses and contact lenses

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You don’t have to wait for these troubling times to be over. You can start your journey towards self-reliant vision today

Refractive cataract surgery will remove your cataracts and help you ditch your dependency on glasses and contact lenses

Who can refractive cataract surgery help?

Can you see yourself below?


You experience clouded, blurred or dim vision. You might have increasing difficulty seeing at night, or notice that colours are fading or yellowing. If that describes you, you might have a cataract. I can help you see clearly again – and often remove your need for glasses or contact lenses at the same time.

Live a richer life without cataract, reading glasses or varifocals

Refractive cataract surgery is an excellent solution if you want a safe and effective treatment for your cataract, and correct your short-sightedness, long-sightedness, astigmatism and presbyopia


Imagine getting your cataract removed and then seeing the whole of the world without the need for glasses or contact lenses. You’ll have a freedom that some patients call “life-changing”.


You don’t have to wait. Most patients say they wish they’d done it sooner. You may feel more confident and will certainly experience more convenience.


Awaken ready to read the morning headlines on your mobile or tablet. Take a shower without the blurriness. Work and exercise without glasses or the dryness of contact lenses. See the world in bright and vivid colour. Stop the constant need to put your glasses on and off. Don’t worry about where you’ve left your readers or needing to keep half a dozen pairs around the house.


Many people with cataracts fail to notice how their lives begin to shrink as they stop doing things they most want to do. After refractive cataract surgery, you can re-engage with the activities and people that bring happiness to your life.


You might feel as fit as you did in your 40s and 50s, so there’s no reason why your eyes shouldn’t be able to keep up. These days, we’re living active lives well into our 60s and 70s – why allow cataracts or glasses to get in the way?

Vision correction enables people of all ages to experience a richer life without spectacles or contact-lenses

I’ll guide you through the sometimes confusing world of vision correction options

Supplementary information about refractive cataract surgery

In my expert hands, you certainly don’t need to know all of the information I’ve included in the toggles below. If you’d like to know how it all works, however, open them and learn more.

Refractive cataract surgery starts traditionally with the removal of your natural lens (the cataract).

Refractive cataract surgery contrasts to traditional cataract surgery in that instead of replacing your lens with a standard lens, I replace it with a lens determined by your prescription.

We can correct all types of eye prescription including:

  • short- and long-sightedness
  • astigmatism.

At the same time I correct the above conditions, I perform your cataract surgery.

The result of refractive cataract surgery should ensure that you enjoy great vision for many years to come.

We usually carry out refractive cataract surgery as day surgery under local anaesthetic with some mild sedation. That means you’ll be awake during the procedure and can go home on the same day.

The operation itself is keyhole surgery. I perform it through 2 or 3 tiny incisions (no longer than 3mm) in the white of the eye.

I fragment the natural lens and remove it through the keyhole incisions. After I remove it, I implant a small plastic lens called an intraocular implant or intraocular lens. I insert it folded up through the keyhole incision, and it unfolds inside your eye after I place it in the correct position.

If you have cataracts in both eyes, I will discuss the option of operating on both eyes at the same time.

If you have mild cataracts, then this is possible, and the vision typically takes 24 to 48 hours to clear. Therefore, surgery on both eyes on the same day is perfectly acceptable.

Essential parts of the assessment are

  1. An eye health assessment to ensure that the eyes are healthy and that there are no eye diseases present.
  2. Biometry – this is a particular test which is used to work out which lines implant to use in each patient. Every patient needs a different strength or power of the lens implant.
  3. Corneal topography to measure astigmatism. Correction of astigmatism during cataract surgery is essential to ensure good outcomes. If you have significant astigmatism, then you’ll need a toric lens implant to get good vision following surgery.

The final parts of the cataract examination are related to counselling you about:

  1. Whether or not you will need glasses after surgery. We will determine this by the type of lens implant that we’ll use. Standard monofocal lens implants can correct the distance vision if you do not have astigmatism, but then you will need reading glasses.
  2. If you have astigmatism, you will need glasses for both the distance and for reading if I don’t implant a toric lens. A toric monofocal lens will correct your distance vision with astigmatism, but you’ll still need reading glasses.
  3. To ensure that you do not need glasses after your operation we nearly always use a multifocal lens implant to enable you to see at all ranges without the need to wear glasses.
  4. If you have astigmatism and want to be completely glasses-free, then a toric multifocal lens implant will correct every aspect of the vision.

Over the past 15 years multifocal lenses have evolved to the point where there are now 2 types of optical multifocal lenses that can be used:

An Extended Depth of Focus (EDoF) multifocal lenses

EDoF lenses are perfect for golfers where the golf ball needs to be in focus from 1 meter to several meters.

70% of patients with these lenses are entirely free from glasses including for reading, but 30% of patients find that although they can read in good light, they need a weak pair of reading glasses to read in dim light.

B Trifocal multifocal lenses

B Trifocal multifocal lenses are perfect for people who want to read and use a computer without needing glasses but are happy to have a very slight compromise in distance vision.

95% of patients are completely free of glasses after we implant B Trifocal lenses, and only 5% of patients find that they need a pair of weak reading glasses on occasions to read in low light levels.

Occasionally very short-sighted patients find that although they can see their computer without glasses, they feel more comfortable using a pair of weak computer glasses when working for many hours at the computer.

When considering the risks of cataract surgery, refractive or traditional, it is essential to recognise that not having surgery also has risks. The cataract will progress over time and when fully mature cataracts can result in total loss of vision.

The risk of permanent loss of vision in one eye after cataract surgery is 1 in 10,000 operations.

The chance of this happening in both eyes is 1 in 12 million operations. The most common cause is an infection, but other rare reasons include retinal problems such as retinal detachment.

The risk of having reduced vision and needing a second operation to correct any problem is 1 in 500. The risk of having a minor issue that requires further treatment with eye drops is 1 in 100.

After surgery, you’ll have a greatly reduced need for glasses or contact lenses. You may find you no longer need them at all.

Take the first step

Find out if your eyes are suitable for vision correction

How it works

Enjoy a life free from glasses and contact lenses in 3 easy steps





Give us a call on 020 3808 7758 and we’ll help guide you towards a first appointment.


I’ll see you before treatment to ensure you’re a good candidate and treat you at one of my Harley Street London facilities.


I’ll supervise your aftercare as you begin to experience a life free of glasses and contact lenses.

Even more information about refractive cataract surgery

I frequently write articles and publish videos to answer people’s most common questions and keep them updated on the latest developments in vision correction. Find out more below…

Affiliations and memberships

I am proud to be associated with these organisations as a member or consultant

About the author

Mr Alex J. Shortt | Consultant Ophthalmic Surgeon

MB BCh MSc PhD FRCOphth PGDipCatRef

I’m Alex Shortt, a highly trained academic researcher and Consultant Ophthalmic Surgeon based in London’s famous Harley Street medical district. I trained and worked as a consultant for 14 years at London’s Moorfields Eye Hospital. I specialise in advanced technologies for correcting vision, including cataract surgery, implantable contact lenses and laser vision correction.

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