What questions should I ask a potential lens replacement surgeon?

Refractive lens exchange (RLE), often called lens replacement surgery, is one of the most life-changing operations in modern eye care. It is also one of the most surgeon-dependent. The lens you receive, how it is calculated, how the operation is performed and how you are looked after afterwards all vary enormously between clinics. Asking the right questions on your consultation is the single most reliable way to protect yourself and get the visual result you are paying for.

This is the checklist I would want a member of my own family to use.

1. Are you a GMC-registered consultant ophthalmologist on the Specialist Register?

Not every doctor performing lens surgery in the UK is a consultant. Ask for the surgeon's full name and GMC number, then check them on the GMC medical register yourself. You want to see the entry on the Specialist Register for Ophthalmology, not just a licence to practise. If the person you meet in clinic is not the person who will operate on you, ask why — and insist on meeting your actual surgeon before the day of surgery.

2. How many lens replacement operations do you personally perform each year?

Volume matters. A UK consultant doing high-quality refractive lens work will typically perform several hundred lens operations a year, including a meaningful number of premium (multifocal, EDOF or trifocal) implants. Ask for a specific number, not a range. Beware of surgeons who quote total clinic volume rather than their personal caseload — you are hiring an individual, not a building.

3. What is your personal complication rate, and how does it compare with national benchmarks?

Every honest surgeon audits their outcomes. Reasonable UK benchmarks include a posterior capsule rupture rate under about 2%, an endophthalmitis (serious infection) rate well below 1 in 1,000, and a refractive accuracy within 0.5 dioptres of target in at least 85–90% of eyes. A surgeon who cannot tell you their own numbers is not auditing their own work.

4. Which lens are you recommending for me, and why that one specifically?

There is no single best lens. Monofocal, enhanced monofocal, EDOF, trifocal and toric versions of each all have real trade-offs in night vision, contrast, halos and reading range. A good surgeon will explain why your eyes, your prescription, your lifestyle and your macular scan point to a particular lens — and will name the alternatives they considered and rejected. If you are only ever offered one brand regardless of the patient, that is a commercial signal, not a clinical one.

5. What measurements and scans will you use to plan my surgery?

Modern RLE planning should include high-quality optical biometry (for example IOLMaster 700 or Argos), corneal topography or tomography, a macular OCT to rule out silent retinal disease, and a dilated retinal examination — especially if you are short-sighted. Ask which IOL calculation formulas are used (Barrett Universal II, Kane, Hill-RBF and Olsen are current benchmarks). If the answer is vague, the planning is vague.

6. What is my realistic chance of being completely glasses-free?

No honest surgeon promises 100%. A well-planned trifocal or EDOF RLE in a suitable patient typically gives around 90–95% spectacle independence for everyday tasks, with a small chance of needing thin readers for very small print or dim light. Ask specifically about night driving, halos, starbursts and reading in low light — these are the trade-offs patients most often wish they had heard about in advance.

7. What happens if the refractive result is not perfect?

Even with modern biometry, a small percentage of eyes end up with a residual prescription. Ask whether a laser enhancement (touch-up) is included in the fee, who performs it, and within what time window. Ask also about IOL exchange — how often it is needed, and whether it is offered in-house if the lens type genuinely does not suit you.

8. Who looks after me in the first 24 hours, the first week and the first year?

RLE is not a day-of-surgery event. You want a named point of contact 24/7 in the first week, a review with the operating surgeon (not just an optometrist) at one day and one week, and a clear one-year follow-up plan. Ask what happens if you develop pain, redness or sudden vision change at 10pm on a Sunday.

9. Where will my surgery be performed, and is the hospital CQC-registered?

In the UK, any facility providing surgical care must be registered with the Care Quality Commission. Ask the name of the hospital, look up its most recent CQC report, and check its infection and safety ratings. A consultant with good outcomes usually operates in hospitals that are themselves rated Good or Outstanding.

10. What is the all-inclusive price, in writing?

The headline price is rarely the whole picture. Ask for a written quote that includes: the consultation, all scans and biometry, both eyes, the lens implants themselves, the anaesthetist, the hospital fee, all follow-up visits for at least 12 months, any YAG laser capsulotomy that becomes necessary, and any laser enhancement if the refractive target is missed. Vague or itemised-later pricing is a red flag.

11. Can I speak to previous patients or read verified reviews?

Independent, verified review platforms such as Doctify and iWantGreatCare confirm each reviewer was a real patient. Google reviews are useful but less strictly verified. A surgeon with a genuine track record will happily point you to their public reviews rather than only in-house testimonials.

12. What is your honest answer if I am not a good candidate?

This is the most important question of all. A surgeon who is willing to tell you that RLE is not the right operation for you — and to recommend laser vision correction, an ICL, or simply waiting — is a surgeon acting in your interest. If every patient who walks through the door is somehow suitable for the most expensive procedure on the menu, that is a warning sign.

Bringing it together

The right lens replacement surgeon for you will answer all twelve of these questions clearly, in plain language, without pressure, and will give you time to think. If you feel rushed, upsold, or unable to speak to the person who will actually operate on you, keep looking.

To discuss your own case with a UK consultant ophthalmologist, you can book a free 15-minute call or request a full consultation.