A cataract is a discoloring or clouding of the normally clear lens that exists behind the pupil of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a fogged-up or dirty window. Clouded vision caused by cataracts can make it more difficult to read, drive a car, or keep your house clean.   Most cataracts develop slowly and don’t disturb your eyesight early on. But with time, cataracts will eventually interfere with your vision.  At first, stronger lighting and eyeglasses can help you deal with cataracts. But if impaired vision interferes with your usual activities, you might need cataract surgery. Fortunately, cataract surgery is generally a safe, effective procedure.  The lens is enclosed in a lining called the lens capsule. Cataract surgery separates the cataract from the lens capsule. In most cases, the lens will be replaced with a plastic intraocular lens implant (IOL).

Phacoemulsification and standard extracapsular cataract extraction (ECCE) are surgical methods that remove the cataract as well as the front portion of the lens capsule (anterior capsule). The back of the lens capsule (posterior capsule) is left inside the eye to keep the vitreous gel in the back of the eye from oozing forward through the pupil and causing problems. The posterior capsule also supports the IOL and helps keep it in the proper position. These types of surgery are usually done in an outpatient setting and not in a hospital.

Phacoemulsification (small-incision surgery) is the most common type of cataract surgery. It is used more often than standard ECCE, even though they are similar procedures.

During phacoemulsification surgery:

Anesthetic eye drops are used to numb the front surface of the eye.  Two small incisions are made in the eye where the clear front covering (cornea) meets the white of the eye (sclera).

A circular opening is created on the lens surface (capsule).

A small surgical instrument (phaco probe) is inserted into the eye.

Sound waves (ultrasound) are used to break the cataract into small pieces. Sometimes a laser is used too. The cataract and lens pieces are removed from the eye using suction.

An intraocular lens implant (IOL) may then be placed inside the lens capsule.

Normally, the incisions seal themselves without stitches.

During standard ECCE:

An anesthetic injection is done behind the eye.  An 8 mm to 10 mm incision is made in the eye where the clear front covering of the eye (cornea) meets the white of the eye (sclera) usually at just above the cornea at 12:00.

Another small incision is made into the front portion of the lens capsule. The lens is removed, along with any remaining lens material.

An IOL may then be placed inside the lens capsule. And the incision is closed with sutures.