Cataract Surgery

Cataract Surgery Options

Once cataract is significantly developed and it becomes difficult to carry out day to day activities, cataract needs to be removed by surgery and replaced by an artificial lens.

Cataract surgery is done in multiple ways, all of which have their pros and cons and their ideal candidates. Your surgeon will discuss these options with you during a personal consultation and after extensive eye examinations to determine the best possible treatment option.

Extracellular Cataract
Surgery (ECCE)

This technique is getting obsolete now. This is slightly more invasive procedure, where the incision made along the side of the cornea-limbus, allowing the cloudy core of the afflicted lens to be expressed out of an eye in one piece and the remainder of the lens to be suctioned out. At the end cornea needs to be sutured.

Manual Small Incision Cataract Surgery (MSICS)

This is little modern version of ECCE. But still it remains invasive surgery. Here also cloudy core of the afflicted lens to be expressed out of an eye in one piece through scleral pocket made along the limbus. This technique doesn’t need suturing of cornea.


Phaco, also known as phacoemulsification or small incision cataract surgery, is the most common cataract surgery. In this procedure, a very small incision is made on the side of the eye’s clear dome-shaped cover called the cornea. Through this tiny incision, the surgeon inserts a probe that safely emits ultrasound waves that break down the cloudy lens so that it can be suctioned out and replaced by an artificial IOL (intraocular lens).

Phacoemulsification is a safe, painless, cataract removal procedure, performed on an outpatient basis under intravenous sedation(if required) with topical anesthesia. It involves two small incisions approximately two millimeters and one millimeter long that are self-sealing and do not require sutures. After the incisions are made, viscous fluid is injected into the eye to protect the tissue and help the eyeball retain its shape.

An ultrasonic phacoemulsification probe is used to break up the cataract into small pieces, which are sucked out of the eye through a small bore at the tip of the probe. After the cataract is removed, a foldable/injectable replacement intraocular lens is implanted through an opening in the lens capsule-a natural position of lens.

Your surgeon will discuss these options with you during a personal consultation and after extensive eye examinations to determine the best possible treatment options.

Phacoemulsification and all other surgeries are usually followed by inserting an artificial replacement lens, called an IOL, or intraocular lens, which come in a wide range of types:

  • Monofocal IOLs can help you focus on at a distance but may require reading glasses.
  • Presbyopia-correcting IOLs can help you to focus on up-close objects
  • Multifocal IOLs help you focus both near and far away, and can be personalized to you, possibly making eyeglasses unnecessary.
  • Extended Depth of Focus IOLs can provide both excellent distant and medium vision, and improved up-close vision

What is recovery like after Cataract?

After your cataract surgery you will be given eyedrops for dry eyes and dark sunglasses to protect against the sun and other bright lights. You may return home the day of the procedure, with instructions to get proper rest and avoid heavy lifting and strenuous activities during your recovery. Do not rub your eye, wear makeup, or get it wet during the first week following surgery. Most patients recover in a few days with little or no discomfort. You will have several follow-up visits with Dr. Manoj Joshi to ensure your eyes are healing properly after surgery.

What are the benefits of Cataract removal?

Improved chances of longer life

In addition to improving quality of life, cataract removal may improve the odds of living longer for people with cataracts. In a recent study published researchers found that cataract surgery is associated with significantly better long-term survival among older people. The study found a 40 percent reduction in mortality risk for people with cataracts who have surgery to remove them, as compared to those who do not.

What is the best lens to get for Cataract surgery?

Toric IOLs

Toric IOLs lenses are designed to correct astigmatism (as well as short-sightedness or long-sightedness) and allow you to see well at a distance.

Monofocal IOLs

Monofocal IOLs have one focusing distance which will be set to focus on close work or reading, medium range sight, or distance vision. The most common choice is the distance vision setting. This is ideal for driving, walking and seeing people at a distance. Monofocal IOLs usually require eyeglasses for seeing things close up.

Multifocal IOLs

A multifocal IOL is designed to help a patient see both near and far early, but the way the lenses alter light in order to achieve this can be difficult for some patients to tolerate.

Which is the best lens for you?

The best lens to choose for cataract surgery depends on your specific vision needs. If you’re comfortable wearing glasses after cataract surgery, a monofocal lens may be the right choice. If you wants greater freedom from eyeglasses at distance and near and can tolerate potential glare or halos around lights, the multifocal intraocular lens may be an option. This decision comes down to what you want in terms of improving your eyesight and lifestyle.

Can eyesight deteriorate after Cataract surgery?

Your eyesight won’t deteriorate after cataract surgery unless another vision problem arises, such as macular degeneration or glaucoma.

If you work with an outstanding surgeon who uses the most modern technology, the chances of vision issues arising because of your cataract surgery are very rare. The most common cause of blurriness in an eye after cataract surgery is posterior capsule opacification. This occurs when a layer of cells grows behind the lens implant. These cells block or scatter light and can cause visual blurring. When this happens, the treatment is a simple YAG laser capsulotomy procedure.

Does Cataract surgery
restore 20/20 vision?

While many people will obtain 20/20 best-corrected vision from their IOL, 30-50% of people who choose a monofocal IOL will still require corrective lenses after surgery. It’s likely you’ll be able to see much better after cataract surgery, but you may still need to wear glasses or contacts, especially for reading, close work and driving. Some patients prefer to achieve this with LASIK.

How long do Cataract lenses last?

IOLs never break down or have to be replaced. However, it’s important to follow aftercare instructions from your doctor to ensure your eyes heal well and properly. Your cataract lens should last a lifetime, and the vast majority of patients don’t experience complications after cataract surgery.

How painful is Cataract surgery?

During your cataract surgery, eye drops are used to numb the eye. You will be awake during your cataract surgery, and you won’t feel pain. A mild intravenous sedative may be administered before the surgery if you prefer this. The surgery takes less than ten minutes. The recovery is relatively painless, with few or no side effects. After your surgery, it’s normal to feel itching and mild discomfort for a couple of days. It’s important to avoid rubbing or pushing on your eye, and to follow the aftercare directions from your doctor.

Why choose Shivam Eye Hospital?

Dr. Manoj Joshi is a renowned ophthalmologist and one of the best eye doctors in Porbandar. He is a board-certified and fellowship-trained specialist with an unparalleled reputation for his surgical work. As much as surgery is his forte, Dr. Joshi works extensively with his patients before surgery to try to address their concerns with any effective nonsurgical means if such is possible.