Laser vs Standard Cataract Surgery: Cost Against the Evidence
By Pauline Driscoll | Medically reviewed by Mr Lewis Pereira, FRCOphth
Published May 20, 2026 · Last reviewed May 30, 2026 · 2 min read
Key takeaways
- Standard cataract surgery uses phacoemulsification, where ultrasound breaks up the cloudy lens through a tiny self-sealing incision.
- Laser-assisted surgery, FLACS, uses a femtosecond laser to perform some steps that the surgeon otherwise does by hand.
- On current evidence, FLACS has not been shown to give better outcomes than standard phaco for routine cataracts.
- Laser-assisted surgery is more expensive and is usually a private, extra-cost option rather than a standard NHS offering.
- For routine cases, the lens you choose matters more to your everyday vision than whether a laser is used.
Laser-assisted cataract surgery (FLACS) uses a femtosecond laser for some steps of the operation, but on current evidence it has not been shown to give better outcomes than standard phacoemulsification for routine cases, and it is more expensive1. Both approaches remove the cloudy lens and replace it with a clear implant, and both achieve very high success rates, so for ordinary cataracts the case for paying extra for the laser is weak2.
This comparison sits under the main cataract surgery guide. To understand the standard method in detail first, read how cataract surgery works, and for the money side see how much cataract surgery costs.
What standard cataract surgery is
Standard cataract surgery uses phacoemulsification, the routine modern technique: through a tiny self-sealing incision of around 2 to 3 mm, an ultrasound probe breaks the cloudy lens into fragments and removes them, and a folded clear lens is inserted3. The surgeon makes the incision and the opening in the lens capsule by hand.
This is the approach the great majority of people have, and it is the one reflected as routine in national clinical guidance1. It is highly effective and quick, typically taking about 15 to 30 minutes per eye.
What laser-assisted surgery adds
Laser-assisted surgery, FLACS, uses a femtosecond laser to perform some of the steps the surgeon would otherwise do by hand, such as the corneal incision and the opening in the lens capsule4. The cloudy lens is still broken up and removed, usually with ultrasound, and a clear implant is still inserted.
In other words, the laser assists with parts of the operation rather than replacing it. The theoretical appeal is added precision on those specific steps.
What the evidence shows
The key point is that, on current evidence, FLACS has not been shown to give better outcomes than standard phaco for routine cases1. Both approaches deliver very high success, with around 9 in 10 people achieving improved vision, assuming no other eye disease2. The added precision of the laser does not reliably translate into better final vision for ordinary cataracts.
This matters because FLACS is more expensive and is usually a private, extra-cost option1. When I was choosing, I asked plainly whether the laser would give me sharper sight, and the honest answer was no for a straightforward cataract like mine. I had standard surgery on both eyes and the result was exactly the bright, clear vision I had hoped for.
Where your money makes more difference
For routine cataracts, the lens you choose generally affects your everyday vision far more than whether a laser was used4. A standard monofocal lens gives excellent distance vision; premium lenses aim to reduce glasses use but carry their own trade-offs.
So if you are weighing where to spend, the lens decision is usually the more meaningful one. Read choosing a lens for cataract surgery, monofocal vs multifocal lenses, and whether premium lenses are worth it before deciding.
References
- Cataracts in adults: management (NG77), NICE. ↩
- Cataract surgery, American Academy of Ophthalmology. ↩
- Cataract surgery, NHS. ↩
- Understanding cataracts: patient information, Royal College of Ophthalmologists. ↩
Common questions
What is the difference between laser and standard cataract surgery?
Standard cataract surgery uses phacoemulsification, where the surgeon makes the incision and opening by hand and an ultrasound probe breaks up the cloudy lens. Laser-assisted surgery, called FLACS, uses a femtosecond laser to perform some of those steps, such as the incision and the opening in the lens capsule. The cloudy lens is still removed and a clear implant inserted in both approaches.
Is laser cataract surgery better?
On current evidence, laser-assisted cataract surgery has not been shown to give better outcomes than standard phacoemulsification for routine cases. Both approaches are highly effective, with around 9 in 10 people achieving improved vision. The laser adds precision to certain steps but does not reliably translate into better final vision for ordinary cataracts.
Is laser cataract surgery worth the extra cost?
For routine cataracts, the extra cost of laser-assisted surgery is hard to justify on outcomes alone, because it has not been shown to give better results than standard surgery. It is usually a private, extra-cost option. The lens you choose generally has a much bigger effect on your everyday vision than whether a laser was used, so that is often where the money makes more difference.
Is laser cataract surgery available on the NHS?
Standard phacoemulsification is the routine technique funded by the NHS when clinical criteria are met. Laser-assisted surgery is more expensive and is generally offered as a private, extra-cost option rather than a standard NHS service, reflecting that it has not been shown to improve outcomes for routine cases.
Does laser cataract surgery use a laser to remove the cataract?
Not entirely. In laser-assisted surgery a femtosecond laser performs some steps, such as the corneal incision and the opening in the lens capsule, but the cloudy lens is still broken up and removed, usually with ultrasound, just as in standard surgery. The laser assists with parts of the operation rather than replacing the whole procedure.
Which type of cataract surgery should I choose?
For a routine cataract, standard phacoemulsification is an excellent, evidence-based choice, and the decision is best made with your surgeon based on your eyes and circumstances. Because laser assistance has not been shown to give better outcomes for routine cases, many people focus instead on choosing the right lens, which affects everyday vision more directly.
Written by Pauline Driscoll. Medically reviewed by Mr Lewis Pereira, FRCOphth.
Our guides are written from personal experience and reviewed by a qualified clinician for accuracy. Read our editorial policy.
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