Cataract Surgery (Phacoemulsification & MICS)
Cataract is not a film growing over the eye that can be dissolved with drops — it is the eye's own lens turning cloudy, and the only treatment is replacing it. Our ophthalmologists use phacoemulsification through a 2 mm incision: 15 to 20 minutes, no stitches, no injection in most cases, and useful vision back the next day. Cashless insurance and a full explanation of which lens actually suits you.
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What is Cataract Surgery?
A cataract is a clouding of the eye's natural lens. That lens sits behind the pupil and is normally completely transparent, focusing light onto the retina. Over time its proteins denature and clump together, scattering light instead of transmitting it, and vision becomes progressively hazy — as though looking through a misted window that no amount of blinking clears.
It is worth correcting a widespread misunderstanding at the outset. A cataract is not a skin, film or membrane growing over the surface of the eye that could be peeled off or dissolved. It is the lens itself that has become cloudy, inside the eye. This is why no eye drop, medication, exercise or diet can reverse a cataract, and why any product claiming to dissolve one is not telling the truth. The only treatment is to remove the clouded lens and replace it with a clear artificial one.
Cataract is overwhelmingly age-related, developing gradually from the fifties onwards, and it is the single largest cause of avoidable blindness in India. But it also occurs earlier: diabetes accelerates it considerably, as do long-term steroid use, eye injury, previous eye surgery, prolonged unprotected sun exposure, smoking and certain congenital conditions. A child born with a cataract needs urgent surgery, because the developing visual pathway will not mature properly if the eye is deprived of clear images.
The type of cataract determines the symptoms, which is why two people with cataracts can describe entirely different problems. A nuclear cataract clouds the centre of the lens and causes gradual blurring with poor distance vision; curiously, it often improves near vision temporarily — the so-called second sight — as it shifts the lens power, which is why some people find they can suddenly read without glasses shortly before their distance vision deteriorates. A cortical cataract produces spokes from the periphery and causes marked glare. A posterior subcapsular cataract sits at the back of the lens directly in the visual axis; it is common in diabetics and steroid users, progresses faster, and causes disproportionate difficulty with bright light and night driving even when the vision chart still looks reasonable.
Surgery has changed beyond recognition. There is no longer any reason to wait for a cataract to become "mature" before operating — that advice belongs to an era of large-incision surgery, and waiting now simply makes the cataract harder and denser to remove, raising the complication rate. Modern phacoemulsification uses ultrasound through a 2 to 2.8 mm incision to break up and aspirate the lens, after which a foldable intraocular lens is inserted through the same opening and unfolds inside the eye. The wound is self-sealing and needs no stitches. Most patients have topical anaesthetic drops only, with no injection and no patch, and walk out seeing better the same evening.
The decision that most affects your result is not the technique but the lens. A monofocal lens gives excellent, crisp vision at one distance, with glasses for the others. Multifocal and trifocal lenses offer spectacle independence but with some loss of contrast and a characteristic experience of halos and glare around lights at night. Neither is universally better, and the honest answer depends on your eyes, your work and your tolerance for compromise.
Treatment information
| Condition | Cataract |
|---|---|
| Procedure | Phacoemulsification with Intraocular Lens Implantation |
| Duration | 15 to 25 minutes per eye |
| Treated by | Ophthalmologist / Cataract Surgeon |
| Anaesthesia | Topical anaesthetic drops in most cases |
| Success rate | Over 98% |
| Recovery time | 1 to 3 days for useful vision; 4 weeks for full healing |
| Hospital stay | Daycare — discharge within a few hours |
Signs you may need Cataract Surgery treatment
- Gradual, painless blurring or clouding of vision
- Glare and halos around headlights and streetlights, making night driving difficult
- Increasing difficulty seeing in bright sunlight
- Colours appearing faded, dull or yellowed
- Needing brighter light to read
- Frequent changes in spectacle prescription over a short period
- A temporary improvement in near vision in older adults (second sight)
- Double vision in one eye that persists when the other eye is closed
- Difficulty recognising faces at a distance
- In a child: a white reflex in the pupil, wobbling eyes, or not fixing on faces — this needs urgent assessment
What causes it?
- Age-related denaturing and clumping of the lens proteins — by far the commonest cause
- Diabetes, which accelerates cataract formation substantially
- Long-term steroid use, whether oral, inhaled or as eye drops
- Blunt or penetrating injury to the eye
- Previous intraocular surgery, including vitrectomy
- Prolonged unprotected exposure to ultraviolet light
- Smoking and heavy alcohol use
- Congenital cataract from intrauterine infection or an inherited metabolic condition
- Radiation exposure
- Chronic intraocular inflammation (uveitis)
Who is more likely to be affected
- Age above 50, with prevalence rising steeply each decade
- Diabetes, particularly when poorly controlled
- Long-term steroid therapy for asthma, arthritis or skin conditions
- Outdoor occupations with high sun exposure and no protective eyewear
- Smoking
- High myopia
- Previous eye injury or eye surgery
- Family history of early cataract
- Chronic dehydration and severe episodes of diarrhoeal illness
When to see a doctor immediately
- Vision that has become blurred enough to interfere with reading, driving or work
- Glare or halos that make night driving uncomfortable or unsafe
- Two or more spectacle prescription changes within a short period
- Any sudden loss of vision, which is not cataract and needs same-day assessment
- Flashes, floaters or a curtain across the vision — these suggest retinal problems, not cataract
- Eye pain, redness or persistent watering
- A white reflex in a child's pupil, or a child not fixing and following — urgent
- Diabetes with any change in vision, since cataract and retinopathy often coexist
How it is diagnosed
Visual acuity and refraction
Vision is measured with and without glasses, and refraction determines whether a change in prescription would improve things. Importantly, glare testing is also done, because a patient can read the chart reasonably in a dim room and still be functionally disabled by glare in daylight — the chart alone underestimates the disability.
Slit lamp examination
The eye is examined under magnification after dilating the pupil. This grades the density of the cataract, identifies its type, and assesses the cornea, iris and the strength of the zonules that suspend the lens — all of which affect how the surgery will be planned.
Dilated retinal examination
The retina and optic nerve are examined to make sure the vision loss is genuinely due to the cataract. This step matters enormously: a patient with coexisting diabetic retinopathy, macular degeneration or glaucoma will not regain full vision after cataract surgery, and knowing that beforehand is what prevents disappointment afterwards.
Biometry
Optical or ultrasound measurement of the eye's axial length and corneal curvature, used to calculate the exact power of the lens to be implanted. The accuracy of this measurement is what determines your final refractive result, and it is the least visible but most consequential part of the entire process.
Corneal topography and endothelial cell count
Topography maps astigmatism, which determines whether a toric lens is appropriate. The endothelial cell count assesses the health of the innermost corneal layer, which is important where the cataract is dense or there has been previous eye surgery.
OCT of the macula
A scan of the central retina, particularly important in diabetics and anyone with reduced vision that the cataract alone does not fully explain. Undetected macular oedema is a common reason for a disappointing result after otherwise perfect surgery.
How the options compare
| Feature | Monofocal Lens | Multifocal / Trifocal Lens |
|---|---|---|
| Distance vision | Excellent, sharp | Very good |
| Near vision | Needs reading glasses | Usually glasses-free |
| Intermediate (screen) vision | Needs glasses | Good with trifocal |
| Contrast sensitivity | Best available | Slightly reduced |
| Halos and glare at night | Minimal | Common, usually settles over months |
| Night driving | Better suited | Can be troublesome for some |
| Neuroadaptation period | None needed | 3–6 months for the brain to adjust |
| Insurance coverage | Usually fully covered | Top-up payment usually required |
| Best suited to | Night drivers, existing retinal disease, cost-conscious patients | Patients prioritising spectacle independence with healthy retinas |
Types of treatment
Before surgery is needed
Updated spectacles
In early cataract, a change of prescription often restores adequate vision for a year or more. This is a legitimate step, not a delaying tactic — surgery is indicated when vision interferes with what you need to do, not when a cataract first appears on examination.
Better lighting and anti-glare measures
Brighter task lighting for reading, anti-glare coatings and good quality sunglasses outdoors all help meaningfully in early cataract, particularly where glare is the dominant symptom.
Controlling contributing factors
Tight blood sugar control, reviewing long-term steroid use with the prescribing doctor, stopping smoking and consistent UV protection all slow progression — though none reverses an existing cataract.
What does not work
No eye drop, tablet, exercise or dietary supplement dissolves or reverses a cataract. Products marketed on that claim do not work. Being clear about this is more useful than being polite about it.
Surgical techniques
Phacoemulsification
The worldwide standard. A 2 to 2.8 mm incision is made, an ultrasound probe emulsifies the cloudy lens and aspirates it, and a foldable intraocular lens is injected through the same opening to unfold inside the capsular bag. The wound seals itself without stitches, and topical anaesthetic drops are usually all that is required.
Micro-incision cataract surgery (MICS)
A refinement using an incision under 2 mm, which induces even less surgically created astigmatism and speeds visual recovery further.
Femtosecond laser-assisted cataract surgery
A laser performs the corneal incision, the circular opening in the lens capsule and the initial fragmentation of the lens before phacoemulsification completes the removal. It offers greater precision and reproducibility, particularly useful for premium lens implantation, at additional cost.
Manual small incision cataract surgery (MSICS)
A sutureless technique through a slightly larger self-sealing tunnel, without ultrasound. It remains genuinely valuable for very dense, hard or advanced cataracts where phacoemulsification would require excessive ultrasound energy, and it is safe, fast and economical.
Choice of intraocular lens
Monofocal lenses give the sharpest single-distance vision and the best contrast. Toric lenses correct astigmatism. Extended depth of focus lenses give distance and intermediate vision with fewer night-time halos than multifocals. Multifocal and trifocal lenses maximise spectacle independence at some cost in contrast and night vision. The right choice depends on your retina, your work and your priorities — and should be discussed properly rather than sold.
What happens, step by step
- 1
Consultation and full eye examination
45–60 minutes- Vision is tested with glare, not just on a chart in a dim room
- The pupil is dilated and the cataract graded at the slit lamp
- The retina and optic nerve are examined to confirm the cataract is the actual cause of your vision loss
- You are told honestly what vision to expect afterwards, including if other eye disease will limit it
- 2
Biometry and lens selection
30–45 minutes- Optical biometry measures the eye precisely to calculate the lens power
- Corneal topography maps astigmatism and determines whether a toric lens is appropriate
- The lens options are explained with their genuine trade-offs, not just their price
- Your occupation, night driving and reading habits are discussed, because they should drive the choice
- 3
Pre-operative preparation
3–7 days before- Blood sugar, blood pressure and general fitness are reviewed
- Antibiotic eye drops are started as prescribed
- Blood thinners are usually continued — cataract surgery does not normally require stopping them
- Any lid infection or blocked tear duct is treated first, as it raises infection risk
- 4
The procedure
15–25 minutes- Anaesthetic drops numb the eye; an injection is needed only in selected cases
- You remain awake, seeing light and movement but nothing distressing
- A 2 to 2.8 mm incision is made and a circular opening created in the lens capsule
- Ultrasound emulsifies the cloudy lens, which is aspirated away
- The foldable intraocular lens is injected and unfolds into the capsular bag
- The wound self-seals without stitches, and a protective shield is applied
- 5
Immediate recovery
2–4 hours- You rest briefly and the eye is checked before discharge
- There is no patch in most cases — you go home able to see
- The drop schedule is explained in writing and demonstrated to you
- The protective shield is worn at night for about a week
- 6
Follow-up and the second eye
4–6 weeks- Review on day one, at one week and at four weeks
- Vision is usually useful from the next day and continues improving over two to four weeks
- The second eye is typically operated one to four weeks after the first
- Final spectacles are prescribed at around four to six weeks, once refraction is stable
How to prepare
- Bring your current glasses and any previous eye records to the consultation
- Tell your surgeon about tamsulosin or similar prostate medication — it affects the pupil during surgery and the surgeon must know in advance
- Disclose diabetes, and bring your recent HbA1c
- Do not stop blood thinners unless specifically instructed; cataract surgery rarely requires it
- Start the prescribed antibiotic drops exactly as directed before surgery
- Wash your hair the day before, since it should be kept dry afterwards for a few days
- Do not wear eye makeup, kajal or face cream on the day
- Arrange for someone to accompany you home — you must not drive after the procedure
Why patients choose this procedure
Vision is restored, not just slowed
Cataract surgery is one of the few operations that genuinely reverses a disability rather than halting its progression. Over 98% of patients achieve significant improvement in vision.
Colours and contrast return
Most patients are struck by how much colour they had lost without noticing, since the change happened so gradually. Whites look white again rather than yellowed.
Glare and night driving improve
Halos around headlights and difficulty in bright sunlight resolve, which for many people is the symptom that was most limiting.
Spectacle dependence can be reduced
With a toric lens astigmatism is corrected, and with a multifocal or trifocal lens most patients manage without glasses for most tasks. Even a monofocal lens usually gives excellent unaided distance vision.
Fifteen minutes, no stitches, no injection
Modern phacoemulsification is performed through a 2 mm self-sealing wound under anaesthetic drops. There is no needle, no patch in most cases, and no stitches to remove.
Reduced risk of falls and better independence
Restoring vision in older adults measurably reduces the risk of falls and fractures, and supports independent living — benefits that extend well beyond the eye itself.
Possible risks and side effects
Endophthalmitis
Infection inside the eye is the most serious complication, occurring in well under one in a thousand cases. It is sight-threatening and needs immediate treatment. Increasing pain, worsening vision or growing redness in the days after surgery must be reported at once rather than watched.
Posterior capsule opacification
Months or years later, the capsule holding the lens can become cloudy, causing vision to blur again. Patients often assume the cataract has returned — it has not, since a cataract cannot regrow. It is corrected in a two-minute painless outpatient YAG laser procedure with immediate improvement.
Posterior capsule rupture
The capsule can tear during surgery, particularly in dense cataracts, in very advanced cases and in eyes with weak zonules. It is managed at the time, though it may require a different lens position and a longer recovery. Operating before a cataract becomes rock-hard reduces this risk.
Refractive surprise
The final spectacle power can differ from the target despite accurate biometry, particularly in very long or very short eyes, and in eyes that have had previous LASIK. Glasses or, occasionally, a lens exchange corrects it.
Cystoid macular oedema
Swelling at the centre of the retina causing blurred vision a few weeks after otherwise successful surgery. More common in diabetics, and usually responsive to drops over several weeks.
Halos, glare and reduced contrast with premium lenses
An expected characteristic of multifocal and trifocal lenses rather than a complication. Most patients neuroadapt over three to six months, but a minority remain troubled — which is why night drivers are often better served by a monofocal lens.
Retinal detachment
Uncommon, but more likely in highly myopic eyes and after a complicated procedure. New flashes, a shower of floaters or a curtain across the vision at any time after surgery require same-day assessment.
What recovery looks like
Recovery after cataract surgery is unusually quick, and most patients are surprised by how little there is to it. The discipline required is almost entirely about eye drops and about not rubbing the eye.
Day of surgery: vision is typically hazy and the eye may water or feel gritty. There is usually no patch, so you can see from the operated eye the same evening. Rest at home, avoid bending forward and wear the protective shield when sleeping. Some improvement in vision is often obvious within hours.
Days 1 to 7: vision improves markedly, and most patients see well enough for normal indoor activity from day one. Use the prescribed antibiotic and anti-inflammatory drops exactly on schedule — this matters more than anything else you do. Do not rub the eye, keep water and soap out of it while bathing, and wear sunglasses outdoors. Reading, watching television and using a phone are all fine and do not harm the eye.
Weeks 2 to 4: vision stabilises and the drops are tapered as directed. Light exercise and walking are fine. Avoid swimming, dusty environments, heavy lifting and any risk of the eye being knocked. The second eye is usually operated during this window.
Weeks 4 to 6: refraction stabilises and final spectacles are prescribed. With a multifocal lens, expect halos around lights at night to be noticeable initially and to reduce over three to six months as the brain adapts.
Contact your ophthalmologist immediately if you develop increasing pain, worsening rather than improving vision, spreading redness, discharge, or a sudden shower of floaters or flashing lights. Pain that increases after the first day is never normal after cataract surgery.
What to eat and what to avoid
Recommended
- Green leafy vegetables such as spinach and methi for lutein and zeaxanthin
- Orange and yellow vegetables — carrot, pumpkin, sweet potato — for vitamin A
- Citrus fruit, amla and guava for vitamin C
- Nuts and seeds for vitamin E and zinc
- Fish, flaxseed and walnuts for omega-3 fatty acids
- Adequate protein to support healing
- Consistent blood sugar control if you are diabetic — this affects both healing and the final result
- 2.5 to 3 litres of water a day
Best avoided
- Rubbing or pressing the eye, which is the commonest cause of avoidable problems
- Smoking, which is directly linked to cataract formation in the other eye
- Excess alcohol
- Bending forward from the waist or lifting heavy weights for two weeks
- Swimming pools, hot tubs and steam for four weeks
- Dusty, smoky environments and gardening for two weeks
- Eye makeup, kajal and face creams near the eye for two weeks
- Missing or 'catching up' on eye drops — the schedule matters more than the dose
Post-operative care, at no extra cost
- Diet and lifestyle consultation with a nutritionist
- Scheduled follow-up calls until you are fully recovered
- Free cab for the follow-up visit
- 24×7 access to your care coordinator for any concern
Cataract Surgery treatment cost
₹25,000 – ₹1,20,000
The cost is driven almost entirely by the intraocular lens chosen rather than by the surgery itself. A monofocal lens sits at the lower end; toric lenses for astigmatism, extended depth of focus and multifocal or trifocal lenses cost considerably more. Femtosecond laser assistance, the density of the cataract, your city, the hospital and your room category also contribute. Cataract surgery is covered by virtually all health insurance policies, though most cap the lens cost at a monofocal equivalent — meaning a premium lens usually involves a top-up you pay yourself. Our insurance desk tells you the exact figure in writing before you decide.
Inside the care journey
Cataract Surgery — your questions answered
No. A cataract is the eye's own lens becoming cloudy, inside the eye — not a film over the surface that could be dissolved. No eye drop, tablet, exercise, or dietary supplement can reverse it, and products marketed on that claim do not work. The only treatment is surgical replacement of the lens. Drops and diet can slow progression at best, but they cannot clear a lens that has already clouded.