What Are the 3 Types of Cataract Surgery
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If you have been told you need cataract surgery, confusion is normal.
Patients often ask me the same questions.
Which cataract surgery is best?
Is laser cataract surgery better?
Will the surgery be painful?
How soon will vision improve?
I am Dr. Rajesh Kapoor, and at Suruchi Eye Hospital & Lasik Centre, my role is not only to perform surgery.
My role is to help you understand what is happening inside your eye and why one cataract surgery technique may suit you better than another.
Let me explain the commonly used cataract surgery options in clear, simple terms.
What is a cataract
Inside your eye is a natural, clear lens.
With age, diabetes, injury, or long-term sun exposure, this lens slowly becomes cloudy.
This clouding is called a cataract.
Eye drops, medicines, or glasses cannot remove a cataract.
Cataract surgery is the only permanent treatment.
The reassuring part is this.
Modern cataract surgery is safe, predictable, and highly successful.
1. Phacoemulsification (Phaco Cataract Surgery)
Phacoemulsification is the most commonly performed cataract surgery today.
How phaco cataract surgery works
A very small incision, usually 2.2 to 2.8 mm, is made.
An ultrasound probe breaks the cloudy lens into tiny fragments.
These fragments are removed, and an artificial intraocular lens is placed.
In most cases, stitches are not required.
Benefits of phaco cataract surgery
- Small incision
- Faster healing
- Minimal discomfort
- Quick visual recovery
- Lower complication risk
Who is phaco surgery suitable for
- Most age-related cataracts
- Patients seeking a faster recovery
- Individuals wanting an early return to daily activities
At Suruchi Eye Hospital, phaco surgery is our preferred technique whenever the cataract density and eye condition allow it.
2. Small Incision Cataract Surgery (SICS)
Small Incision Cataract Surgery, or SICS, is a proven and dependable technique.
How SICS works
A self-sealing incision, slightly larger than phaco, is created.
The cataract is removed manually in one piece.
An artificial lens is placed inside the eye.
When SICS is recommended
- Moderately hard cataracts
- Eyes where phaco may not be ideal
- Situations where limiting ultrasound energy is safer
What patients should expect with SICS
- Recovery is slightly slower than phaco
- Vision improves steadily
- Outcomes are reliable and safe
SICS is not inferior surgery.
When chosen correctly, it delivers excellent results.
3. Extracapsular Cataract Extraction (ECCE)
In some cases, the cataract is extremely hard or long-standing.
When phaco or SICS is not the safest option, extracapsular cataract extraction is considered.
How ECCE works
A larger incision, around 9 to 10 mm, is made.
The cataract is removed in one piece.
The posterior lens support is preserved for the placement of an artificial lens.
Stitches are usually required.
When ECCE is necessary
- Very dense or mature cataracts
- Long-neglected cataracts
- Eyes where ultrasound energy may cause damage
Recovery after ECCE
- Slower recovery compared to phaco or SICS
- Vision improves gradually
- More post-operative care is needed
ECCE is selective, not outdated.
Used appropriately, it protects the eye.
The modern cataract surgery techniques we use today
Cataract surgery continues to evolve.
At Suruchi Eye Hospital, we focus on techniques that reduce surgical trauma and improve recovery quality.
Zepto-Assisted Cataract Surgery (ZACS)
Zepto-assisted cataract surgery uses a Zepto probe for selected steps of the procedure.
The Zepto helps to:
- Create Perfect round Capsulorhexis
- Improve accuracy of lens positioning
Zepto is used along with phaco, not as a replacement.
Who benefits from Zepto-assisted cataract surgery
- Patients choosing premium lenses
- Those seeking higher surgical precision
Zepto enhances surgical accuracy.
It does not replace surgical judgment.
Micro-Incision Cataract Surgery (MICS)
This is an advanced form of phaco.
The incision is even smaller, often under 2.2 mm.
Benefits of micro-incision surgery
- Minimal tissue disturbance
- Faster healing
- Lower risk of infection
- Quicker return to daily life
Most patients are surprised by how normal their eyes feel within days.
With a smaller incision, the cornea is disturbed less during surgery. This helps maintain the natural shape and strength of the eye, which plays a key role in how quickly vision stabilises after the procedure.
Because the wound is very small, it usually seals on its own. In most cases, stitches are not required. This reduces post-surgery irritation and lowers the chances of stitch-related discomfort or redness.
A smaller incision also improves wound stability in the early healing phase. This is important in reducing fluid leakage and minimising the risk of infection during the first few days after surgery.
Patients often experience less redness, minimal watering, and very mild discomfort compared to larger-incision techniques. Many are able to resume routine indoor activities within a short period, as advised by the doctor.
Micro-incision surgery also helps reduce post-operative corneal swelling. Less swelling means clearer vision earlier and fewer visual fluctuations during recovery.
This technique is especially useful for patients who value faster functional recovery, post-surgical comfort, and minimal disruption to daily life. However, it is always chosen based on cataract density and overall eye health, with safety as the top priority.
How we choose the right cataract surgery for you
There is no single best cataract surgery for every patient.
I consider:
- Cataract hardness
- Age and daily routine
- Overall eye health
- Presence of diabetes or glaucoma
- Visual expectations after surgery
Some patients prioritise faster recovery.
Others need maximum safety.
Some require advanced lens correction.
The goal is always to match the technique to the eye.
What recovery usually feels like
Cataract surgery is usually painless.
After surgery, you may notice:
- Mild irritation
- Slight watering
- Temporary blurred vision
Vision improves steadily over days to weeks.
Eye drops and follow-up visits are important.
Patients undergoing phaco or micro-incision surgery usually resume routine activities quickly.
A final word from me
Cataract surgery is not something to fear.
It is something to understand.
When you understand your options, you feel confident.
When you feel confident, recovery is smoother.
At Suruchi Eye Hospital, we focus on:
- Safe modern cataract surgery
- Personalised treatment planning
- Comfortable and predictable recovery
If you are experiencing cataract symptoms, a proper eye evaluation is the first step.
An informed decision always leads to better outcomes.
