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Cataract surgery in the United Kingdom: patient characteristics, surgical patterns, and clinical outcomes in the National Health Service and a private-sector provider

Year: 2026

Type: article

Abstract: To describe differences in patient population, practice patterns and outcomes between private and public setting cataract surgery. Preoperative population and clinical outcomes from the Royal College of Ophthalmologists National Ophthalmology Database study (2010 NOD; surgeries August 2006 to November 2010), the latest annual audit (2025 NOD; surgeries April 2023 to March 2024), and consecutive cataract surgeries performed at a United Kingdom-based network of private surgical centres (Optical Express) between April 2023 and March 2024 were reviewed. The number of treated eyes was 180,144, 550,519, and 4,969 in the 2010 NOD, 2025 NOD, and private centres, respectively. Private patients were on average one decade younger and had better preoperative visual acuities. Vision loss (≥ 0.3 logMAR) was recorded in 1.5% of eyes in the 2010 NOD, 0.46% in 2025 NOD, and 0.26% in the private cohort. The incidence of posterior capsule rupture decreased from 1.95% in 2010 to 0.69% in 2025 in the NOD; the rate in the private cohort was 0.18%. As the cohorts differed in baseline characteristics, the observed differences should be interpreted cautiously. In the private cohort, implanted IOLs were monofocal (24.8%), enhanced monofocal (54.0%), or multifocal (21.2%), whereas NOD patients typically received conventional monofocal IOLs. Among private patients, immediate sequential bilateral cataract surgery was performed in 57.4%, while its uptake in NOD cohorts was negligible. Private patients underwent surgery at a younger age and with better preoperative visual acuity, consistent with less advanced cataract. Outcome metrics improved markedly between the 2010 and 2025 NOD cohorts.

Source: BMC Ophthalmology

DOI: 10.1186/s12886-026-05361-z