Prof Dan Lindfield

SLT is a laser treatment used for open-angle glaucoma and ocular hypertension. It works by gently stimulating (or “tickling”) the cells in the trabecular meshwork (the eye’s drainage system) to improve aqueous humour outflow, which lowers intraocular pressure (IOP).

• ALT (Argon Laser Trabeculoplasty) can damage the trabecular meshwork because it uses heat, leading to structural changes. Because of that, it carries a higher risk of side effects, and is now rarely used in the UK. 

• MLT (Micropulse Laser Trabeculoplasty) uses a laser that pulses on and off to reduce heat buildup. Its effectiveness and risks are similar to SLT, but whether it causes less inflammation is still under study.

• It’s a safe and effective option that can reduce eye drops or delay their use. 

• After SLT, many patients can go 2 to 4 years without needing daily glaucoma medication, while achieving pressure reduction similar to one drop of medication. 

• It has quick recovery (often 1-2 days), is done as an outpatient procedure (no overnight stay), and takes only a few minutes per eye. 

• It reduces the need for more invasive eye surgery and may slow disease progression. There’s also evidence it might reduce the risk of cataract development. 

Although generally very safe, SLT has potential mild side effects:

• Mild redness or ache in the eye, which resolves in a few days. 

• Sensitivity to light (photophobia), also temporary. 

• A short-term increase in eye pressure in rare cases; prevented or treated with drops/tablets. The risk is very low (~1 in 800) with modern techniques. 

• Very rare complications such as iris adhesions, corneal or macular oedema have been reported but are very uncommon. 

MIGS (Minimally Invasive Glaucoma Surgery) refers to a group of less invasive surgical procedures for glaucoma that aim to lower intraocular pressure (IOP) by improving the drainage of fluid inside the eye, or reducing its production. These approaches are generally safer, with faster recovery, fewer complications, and often preserve more of the eye’s natural anatomy. Glaucoma UK

MIGS is generally suitable for people with mild to moderate glaucoma. It’s commonly performed along with cataract surgery, since removing a cataract can itself help reduce IOP. The eye anatomy (especially the drainage angle) and disease stage are evaluated to assess whether MIGS is a good option. Glaucoma UK

It depends. For some people, MIGS reduces IOP enough that they can reduce or even stop some eye drops, at least for a while. But this effect may only last a few years, and some medications may still be needed. Importantly, MIGS doesn’t reverse any existing damage to the optic nerve; the goal is to prevent further damage.

Alternatives include:

• Glaucoma medications (eye drops) Glaucoma UK

• Laser treatments Glaucoma UK

• More invasive glaucoma surgeries, such as trabeculectomy or aqueous shunt surgery Glaucoma UK

Dr Dan Lindfield is a Consultant Ophthalmic Surgeon providing cataract surgery in Farnham, Surrey. He is based at Farnham Eye Care and offers consultant-led assessment, modern cataract surgery, and personalised lens selection for local patients.

Cataract consultations and treatment with Dr Dan Lindfield are provided at Farnham Eye Care in Farnham, Surrey. This location is convenient for patients from Farnham and nearby Surrey and Hampshire towns seeking private cataract surgery.

Yes. Dr Lindfield discusses lens options, including lens upgrades and toric lenses for astigmatism, where clinically appropriate. All options are explained clearly so patients can make informed decisions based on their visual needs and lifestyle.

Yes. Many patients consult Dr Lindfield privately after experiencing delayed or cancelled NHS cataract appointments. Private consultation allows timely assessment, treatment planning, and continuity of care with a consultant ophthalmic surgeon.

Common symptoms include blurred or cloudy vision, glare or halos around lights, difficulty driving at night, and reduced contrast or colour clarity. A consultation with Dr Lindfield can confirm whether cataract surgery is appropriate.

Yes. Dr Lindfield performs YAG laser capsulotomy at Farnham Eye Care for patients with posterior capsule opacification (PCO) causing blurred vision after cataract surgery.

Yes. Dr Lindfield provides glaucoma assessment, monitoring, and treatment for patients in Farnham and surrounding Surrey and Hampshire areas, including medical management, SLT laser treatment, and minimally invasive glaucoma surgery (MIGS).

Yes. Dr Lindfield provides glaucoma assessment, monitoring, and treatment for patients in Farnham and surrounding Surrey and Hampshire areas, including medical management, SLT laser treatment, and minimally invasive glaucoma surgery (MIGS).

Patients regularly attend from Farnham, Guildford, Aldershot, Fleet, Godalming, Haslemere, and nearby Surrey and Hampshire locations.

Dropless cataract surgery is an approach where key medications are given during the cataract operation, reducing or sometimes removing the need for routine post-operative medicated eye drops. The aim is fewer drops, for fewer days, while maintaining safety and effectiveness.

Not always. Many patients require fewer drops, and some may not need routine antibiotic or steroid drops. However, lubricating drops for comfort or pressure-lowering drops may still be advised in certain cases. The plan is individualised.

Common elements include:

• An intracameral antibiotic placed inside the eye at the end of surgery

• A long-acting steroid to control inflammation

• Sometimes an anti-inflammatory medicine (NSAID) depending on risk factors

This approach ensures key medications are in place before the patient goes home.

For carefully selected patients, outcomes are comparable to traditional drop-based regimens. Safety relies on appropriate patient selection, informed consent, and post-operative monitoring, particularly of eye pressure.

Yes. In the UK, standard cataract care already includes an intracameral antibiotic at the time of surgery. This is recommended by National Institute for Health and Care Excellence (NICE) to reduce the risk of endophthalmitis, a serious eye infection.

Dropless approaches may not be appropriate for everyone. Patients with:

• glaucoma or ocular hypertension

• known steroid sensitivity

• uveitis or significant retinal disease

• previous complex eye surgery

may require a tailored plan that still includes drops.

Yes, in some patients. Long-acting steroids can cause a rise in intraocular pressure, particularly in those with glaucoma or known steroid response. This is why follow-up and monitoring are important.

Patients often value:

• less stress managing complex drop schedules

• greater independence after surgery

• reduced reliance on family or carers

• fewer missed doses

For many, it makes recovery simpler and more manageable.

Reducing post-operative drops can lower plastic waste and repeat prescriptions. The Royal College of Ophthalmologists highlights sustainability as an important consideration in high-volume procedures such as cataract surgery.

Patients may wish to ask:

• Am I a suitable candidate for a dropless or “less-drops” approach?

• What medicines will be given during surgery?

• What drops, if any, will I still need at home?

• How will inflammation and eye pressure be monitored afterwards?

Professor Dan Lindfield notes that dropless cataract surgery offers many advantages with relatively few disadvantages for appropriately selected patients, and that choice and clear explanation are essential so decisions can be personalised.