NHS patients to be offered drop-free cataract surgery by private provider

NHS patients in England will be able to access a form of cataract surgery that removes the need for the multiple daily eye drops commonly prescribed in the weeks after the operation, the provider Optegra said.

Optegra, a private firm that carries out surgery on behalf of the NHS, said a clinical trial of its "drop-free" technique found it to be as safe as the standard post-operative regimen. The method delivers small doses of antibacterial and anti-inflammatory medication, including a steroid, directly into the eye during the procedure, rather than relying on patients to apply eye drops up to several times a day for up to a month.

Cataract removal is one of the most frequently performed operations in England, with nearly 700,000 procedures carried out each year. The operation, typically performed under local anaesthetic and lasting less than 30 minutes, replaces the eye's cloudy lens with an artificial one. After surgery, patients commonly receive antibacterial, anti-inflammatory and lubricating drops to reduce infection risk and inflammation and to aid healing.

Under current practice, patients may be prescribed up to four different sets of eye drops, often administered several times a day, for a period that can extend to about four weeks. Optegra's medical director and consultant ophthalmic surgeon, Dr. Alastair Stuart, said the routine places a practical burden on many patients, some of whom require assistance from family or carers to administer drops multiple times daily.

"By providing a steroid and antibacterial treatment during the procedure, all this medication is provided in one go," Dr. Stuart said. "Once the treatment is complete the patient can relax without any further action and with the reassurance that all medications have been provided."

Optegra said the drop-free option will be offered at its clinics across the country to NHS patients. The company treats more than 170,000 patients each year on behalf of the NHS and has increasingly run dedicated clinics under contract to help reduce waiting lists for routine procedures such as cataract surgery.

Clinical adoption of intraoperative injections as an alternative to post-operative drops has been discussed in ophthalmic practice for several years. Proponents highlight improved adherence and convenience, particularly for older patients and those with physical or cognitive difficulties who may struggle to administer drops reliably. Critics and regulators have emphasised the need for robust safety data and clear protocols to monitor outcomes, including rates of infection and inflammation.

People over the age of 65 and those with diabetes are at higher risk of developing cataracts. Smoking, heavy alcohol use and poor diet are also associated with increased risk. In advanced cases, untreated cataracts can lead to severe vision impairment or blindness.

Optegra described the trial results as supporting the safety of the intraoperative injection approach compared with the conventional post-operative drop regimen but did not publish detailed outcome figures in its announcement. The NHS and clinical commissioning bodies will consider the evidence as the option is rolled out to patients. Hospitals and independent providers offering cataract surgery are expected to follow national guidance and local governance processes when introducing new clinical pathways.

As the NHS continues to address elective surgery backlogs, arrangements with independent providers to expand capacity have been a prominent element of planning. The introduction of a drop-free option aims to reduce the post-operative burden on patients while maintaining clinical standards for safety and recovery.

Patients scheduled for cataract surgery should discuss post-operative care and medication options with their surgeon or clinical team, who can explain whether intraoperative medication is suitable for their individual circumstances and outline any specific follow-up arrangements.