Combined Cataract & Glaucoma Surgery London | Dr Emma Jones

Combined Cataract & Glaucoma Surgery London

Dr Emma Jones

Specialist expertise in combined procedures

When you have both cataracts and glaucoma, you face an important decision: have separate surgeries months apart, or combine both procedures in a single operation. Combined surgery requires exceptional expertise in both areas – something that comes from fellowship training that very few surgeons possess.

With more than 25 years of experience and specialist training in both cataract and glaucoma surgery, I’m one of a select group of consultants who can safely and effectively perform these complex combined procedures. As Deputy Service Lead for the Moorfields Glaucoma Service and Fellowship Director training surgeons internationally, I understand how to optimise outcomes when treating multiple eye conditions simultaneously.

Understanding combined surgery

What is combined surgery?

Combined cataract and glaucoma surgery involves removing your cloudy lens (cataract) and creating a new drainage pathway to lower eye pressure (glaucoma treatment) in a single procedure.

This approach requires meticulous surgical planning and expertise in both specialities.

Types of combined procedures I perform

Cataract surgery with trabeculectomy

Traditional glaucoma surgery combined with lens replacement

Cataract surgery with tube/shunt insertion

For more advanced glaucoma cases

Cataract surgery with minimally invasive glaucoma surgery (MIGS)

Modern techniques with faster recovery

Why consider combined surgery?

Rather than undergoing two separate procedures months apart, combined surgery offers:

  • Single recovery period instead of two
  • Some patients have less drops or even no drops for their glaucoma long term
  • The opportunity to have better long-term pressure control
  • More convenient for patients with busy lives

Who benefits from combined surgery?

Ideal candidates

Combined surgery works best for patients who have:

  • Both significant cataracts and mild glaucoma or ocaulr hypertension requiring treatment
  • Good overall eye health apart from these conditions
  • Realistic expectations about recovery and outcomes
  • Preference for single procedure over multiple surgeries

Medical considerations

Your suitability depends on several factors:
  • Severity of both your cataract and glaucoma
  • Your eye’s anatomy and previous surgical history
  • Current glaucoma medications and their effectiveness
  • Overall health and ability to tolerate longer surgery
  • Your risk of scarring, which can affect the success of combined surgery

When separate surgeries might be better

Some patients benefit more from staged procedures:
  • Advanced glaucoma requiring complex surgery and urgent low pressures
  • Complicated cataracts with additional eye conditions
  • Previous eye surgery creating technical challenges
  • Patient preference for shorter individual procedures
  • Patients at high risk of scarring

The combined surgery process

Comprehensive pre-operative assessment

  • Detailed measurement of both cataract density and glaucoma severity
  • Advanced imaging to plan optimal surgical approach
  • Discussion of lens options (standard or premium)
  • Clear explanation of the combined procedure steps
  • Realistic timeline for recovery and visual improvement

Surgical technique

Combined procedures typically take 45-90 minutes depending on complexity:
  1. Cataract removal – ultrasonic lens fragmentation and removal
  2. Lens implantation – precise placement of your chosen lens
  3. Glaucoma procedure – creation of new drainage pathway or device insertion
  4. Pressure management – careful balancing of eye pressure during healing

What makes the difference

Success depends on:
  • Surgeon expertise in both specialities
  • Careful patient selection
  • Meticulous surgical technique
  • Specialist post-operative care
  • Patient compliance with recovery instructions

Recovery and outcomes

Immediate post-operative period

  • Vision improvement noticed within days to weeks
  • Eye pressure monitoring at regular intervals
  • Carefully managed medication regimen
  • Gradual return to normal activities
  • Close monitoring for any complications

Expected outcomes

Most patients experience:
  • Significant improvement in vision clarity
  • Better glaucoma pressure control
  • Reduced need for glaucoma medications
  • Single recovery period rather than two
  • High satisfaction with decision for combined approach

Realistic expectations

Combined surgery success rates are excellent, but outcomes depend on:
  • Pre-operative condition of both cataract and glaucoma
  • Individual healing response
  • Compliance with post-operative care
  • Any unexpected complications during healing

Why choose me for combined surgery

Specialist glaucoma expertise with comprehensive surgical skills

My specialist glaucoma fellowship at Moorfields, combined with extensive experience in complex cataract surgery, provides the comprehensive expertise needed for optimal combined surgery outcomes. As Fellowship Director for the Glaucoma Programme, I understand how to coordinate both procedures for the best possible results.

Leadership experience

As Deputy Service Lead for Moorfields Glaucoma Service and Fellowship Director, I train other surgeons in these advanced techniques and stay at the forefront of surgical innovation.

Complex case experience

I regularly manage the most challenging combined cases referred from across the UK, giving me extensive experience with every type of cataract and glaucoma combination.

Comprehensive approach

Rather than simply performing two procedures together, I optimise the entire surgical plan to achieve the best possible outcomes for your specific situation.

Planning your combined surgery

Initial consultation

Your journey begins with a comprehensive assessment where I’ll examine both conditions thoroughly and discuss whether combined surgery is your best option.

Decision-making process

  • Honest assessment of suitability for combined approach
  • Clear explanation of risks and benefits
  • Time to consider your options without pressure
  • Second opinion always welcome if desired

Surgical planning If we proceed with combined surgery:

  • Detailed pre-operative measurements and planning
  • Discussion of lens choices and expectations
  • Clear timeline and recovery instructions
  • Coordination with your referring optometrist or GP

Frequently asked questions about Combined Cataract & Glaucoma Surgery

Is combined surgery more risky than separate procedures?
In suitable candidates, combined surgery can actually be less risky overall than two separate operations. However, individual risk depends on your specific condition and will be discussed thoroughly.

How long does recovery take?
Most patients notice vision improvement within a week, with full recovery typically taking 6-12 weeks. This is similar to cataract surgery alone, but with added glaucoma benefits.

Will I still need glaucoma drops after surgery?
Many patients require fewer glaucoma medications after combined surgery, and some may not need any. However, this varies depending on individual healing and pressure control.

Can I have premium lenses with combined surgery?
In many cases, yes. The choice depends on your eye health, glaucoma severity, and visual goals. We’ll discuss all options during consultation.

What if the combined surgery doesn’t work?
While success rates are high, additional glaucoma procedures can be performed if needed. The cataract surgery component is typically successful regardless.

Book your combined surgery consultation:

Clinica London, Harley Street – comprehensive consultation and surgical facilities

Moorfields Private (Bath Street, New Cavendish Street, City Road) – access to advanced diagnostic equipment

Initial consultation: £300 – includes comprehensive assessment of both conditions and clear treatment recommendations

Insurance accepted: Allianz, Aviva, AXA PPP, Bupa, Cigna, Healix Health Services, Vitality, and WPA

  • Multiple convenient London locations
  • Same-day appointments often available
  • Comprehensive assessment and clear treatment planning
  • All major insurers accepted
  • Transparent pricing for self-pay patients