A surgeon in Essex has pioneered a technique in which one eye is given a new distance lens and the other a lens for reading. The results, he says, have delighted him and astonished his patients.

Rajesh Aggarwal, an NHS consultant ophthalmic surgeon, uses plastic lenses originally developed for people needing cataract surgery and proven effective over many years. Increasingly in his private practice, he is fitting them to patients who do not have cataracts, but merely deteriorating sight. Now he has started “mixing and matching” lenses so that the need for glasses is usually eliminated.

Removing the natural lens from an eye and filling the space with plastic sounds an extreme measure. But many people are fed up with glasses or contact lenses, finding them incompatible with their lifestyle.

Mr Aggarwal’s first patient for the mix-and-match operation was Stephen Hill, 49, a car dealer and martial arts instructor. His eyesight was getting slowly worse.

Mr Aggarwal first replaced the lens in Mr Hill’s right eye with one designed for intermediate and distance vision. People given this lens normally need to use glasses for close work, such as reading.

The operation was a success but Mr Hill found reading glasses tiresome. So when he returned, Mr Aggarwal suggested that the lens in the left eye was replaced with one designed for short and intermediate vision.

This was not entirely a shot in the dark. “A surgeon in the US had done it successfully,” Mr Aggarwal said. “So I sat Mr Hill down and we talked it through for about 40 minutes, reviewing the pros and cons. I told him I had never done this before.” Mr Hill had the operation three months ago.

“It was so simple,” he said. “There was absolutely no pain. The results are wonderful as the clarity is fantastic. I have thrown away my glasses and I can read anything I like.

“I was so elated the next day I walked the three miles to my showroom because I wanted to see everything and take it in.”

The puzzle is that the brain seems quite able to accommodate two eyes that see the world differently. “I was worried that you would overtax the brain,” Mr Aggarwal said. “But the problem simply doesn’t seem to arise.”

Mr Aggarwal’s next patient was a woman golfer with a problem common in middle age: presbyopia, when the ability of the eye to change focus diminishes.

A common symptom of this is that sufferers’ arms seem too short to hold books at a comfortable distance. This patient was also given a combination of lenses and agreed to the operation after chatting to Mr Hill.

“So far I have done about ten, and they have all been very very good,” said Mr Aggarwal, whose private eye hospital, the Phoenix, is in Southend.

The procedure is done under local anaesthetic and takes less than half an hour. A tiny incision is made to allow access to the lens, which lies in the front third of the eye.

Mr Aggarwal describes the lens as like “a boiled sweet inside an envelope”. The next stage is to dissolve it using ultrasound and vacuum it out, before repacing it with an artificial plastic lens that is rolled up for insertion through the tiny hole into the envelope. Once inside it unrolls to create an artificial lens.

Artificial lenses are bifocal, providing close and intermediate, or intermediate and long. vision. Mr Aggarwal combines them. The operation costs £2,500 per eye, and is not usually available on the NHS.

Mr Aggarwal does some NHS work, but the price of an NHS cataract operation, £800, limits the choice of lens and patients are not allowed to pay to upgrade to a better lens.

Seeing trouble

• Two million people in Britain say they have a sight problem or seeing difficulty
  
• Presbyopia is derived from Greek words meaning "old eye". Most people start to notice the condition about the age of 45
  
• The procedure to treat presbyopia is similar to cataract operations. About 270,000 cataract operations are done in Britain each year
  
• About 35 per cent of people suffer refractive errors which result in blurred vision. The categories are myopia (shortsight), hypermetropia (longsight) and astigmatism

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