Cataract surgery techniques, and choosing a lens
Dr. Swati Goyal · 18 October 2024 · 6 min
Cataract surgery is done by one of two main techniques, and then comes the decision of which lens to implant. Both choices are made around your eye and around the life you lead.
Technique 1: manual small-incision surgery (SICS)
This is done through an incision of roughly 5.5 to 7 mm. It is called “small incision” because older cataract surgery used a 10 to 12 mm cut and required stitches. Against that, this incision is small — hence the name.
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No stitches are needed.
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Healing is good, and begins within about ten days.
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Where the cataract is very advanced, surgeons usually prefer this technique.
Technique 2: phacoemulsification
In phaco a probe containing a piezo-electric crystal uses ultrasonic energy to break the cataract into small pieces and clear them out. The incision here is only two to two and a half millimetres.
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Recovery and healing time are much shorter — patients get back to normal quickly.
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Results are good, and the residual spectacle number tends to be lower than with SICS, because the incision is smaller.
The types of lens
Once the cataract is removed a lens goes in, and here there are a number of options.
Monofocal lenses
First comes the monofocal lens. These are made by Indian companies and also imported — made in the USA, Japan, Germany.
People who spend long hours in the sun or out in the fields — farmers, drivers — can struggle with glare. For them a yellow-coated lens is usually preferred: it filters out excess UV, so only as much light enters the eye as is needed to see.
Multifocal lenses
Moving towards the premium options, there are multifocal lenses. In everyday terms these work like progressive glasses, which carry both a distance and a near number. Rings on the lens correct distance vision, while the clear central zone handles near vision.
With a multifocal lens, dependence on glasses after surgery is greatly reduced — for most everyday tasks you will not need them.
Which technique and which lens is right for you can only be settled after your eye has been examined. Ask your eye specialist openly about the benefit and the cost of each option — and about what actually suits the work you do.