If cataracts are making it harder to read, drive, watch television or enjoy your usual activities, your eye doctor may recommend cataract surgery.
Cataract surgery is a common procedure that removes the eye’s cloudy natural lens and replaces it with a clear artificial lens. But you may be surprised to learn that there is more than one way to perform cataract surgery. Understanding the different types can make it easier to discuss which approach may be right for you.
Phacoemulsification Cataract Surgery
Phacoemulsification, often called “phaco,” is the most commonly used cataract surgery technique. During the procedure, the surgeon makes a very small opening in the eye. A tiny instrument uses ultrasound energy to gently break the cloudy lens into small pieces. Those pieces are then removed from the eye and a clear artificial lens, called an intraocular lens or IOL, is placed inside the eye.
Because the incision is small, stitches are usually not needed.
Good For:
- Many patients with age-related cataracts
- Patients who are candidates for a small-incision procedure
- A wide range of cataract types and vision needs
May Not Be Best For:
- Certain very dense or advanced cataracts
- Eyes with specific conditions that make another surgical approach safer or more appropriate
Laser-Assisted Cataract Surgery
Laser-assisted cataract surgery uses a femtosecond laser to perform certain steps of the procedure that would otherwise be completed with surgical instruments.
The laser may be used to create precise openings in the eye and soften or break apart the cataract before it is removed. The surgeon then removes the cloudy lens and replaces it with an IOL, just as with traditional cataract surgery. While laser assistance can offer added precision, it is not necessarily the best choice for every patient.
Good For:
- Patients who may benefit from additional precision
- Some patients who are also having astigmatism addressed
- Patients whose eye anatomy makes laser assistance beneficial
May Not Be Best For:
- Patients who are unlikely to gain an additional benefit from laser assistance
- Certain eye conditions or anatomical differences
Extracapsular Cataract Surgery
Extracapsular cataract extraction, sometimes called ECCE, is an older technique that requires a larger incision than phacoemulsification. Instead of breaking the cataract into small pieces, the surgeon removes the cloudy portion of the lens through the opening and replaces it with an artificial lens.
Because modern phacoemulsification works well for most patients, this technique is used less frequently today but can still be useful in certain situations.
Good For:
- Some very advanced or extremely dense cataracts
- Certain complex cases where phacoemulsification may not be appropriate
May Not Be Best For:
- Most routine cataract procedures
- Patients who are good candidates for small-incision surgery
Manual Small-Incision Cataract Surgery
Manual small-incision cataract surgery, or MSICS, removes the cataract through a relatively small opening without using the same ultrasound process as phacoemulsification. The cloudy natural lens is removed and replaced with an artificial lens.
It is used more commonly in some parts of the world and may also be helpful for certain advanced or very dense cataracts.
Good For:
- Certain advanced or very dense cataracts
- Cases in which ultrasound-based surgery may not be preferred
May Not Be Best For:
- Many routine cataract surgeries in the United States
- Patients who are good candidates for phacoemulsification
Which Type of Cataract Surgery Is Best?
There is no single type of cataract surgery that is best for everyone.
The right approach depends on the type and severity of your cataract, the overall health of your eyes, your vision needs and other factors specific to you. For many patients, phacoemulsification is a common and effective choice, while other techniques may be better suited for advanced or complex cataracts.
Choosing the Right Cataract Surgery for You
You do not have to decide which cataract surgery is right for you on your own.
The Cataract Surgeons will carefully evaluate your eyes, take detailed measurements and talk with you about how cataracts are affecting your daily life and what you hope to achieve with surgery.
Based on your eye health, cataract severity and individual needs, The Cataract Surgeons can explain your options and recommend the approach that may be best for you.
