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Cataract Surgery Performed by an Ophthalmologist

Cataract Surgery is one of the most common eye surgeries performed by an Ophthalmologist in the world today, and South Africa is no exception. This surgical procedure is used to remove the cloudy natural cataract lens of a patient through either emulsification of the lens or by cutting it out. The cloudy cataract lens is then replaced with an artificial intraocular lens, or IOL for short, which is implanted by the Ophthalmologist performing the surgery. Please note that Cataract Surgery is performed under anaesthesia in a medical setting at either a surgical centre or a hospital.

Types of Cataract Surgery

There are two main types of Surgical Cataract procedures which are commonly used today. These are phacoemulsification or phaco, and the extracapsular cataract extraction or ECCE. During most Cataract Surgeries, an intraocular lens is also inserted. 


Please note that foldable lenses are generally used for the 2-3mm phaco incision and non-foldable lenses are used for the larger extracapsular incision. Phacoemulsification is the most popular Cataract Surgical Method globally as the small incision size often allows for a "suture less" incision closure to be performed. 

The most prevalent surgical techniques used in Cataract Surgery are as follows:


Phacoemulsification (Phaco):

This procedure entails the use of an item of  Ophthalmological Equipment which utilises an ultrasonic hand piece equipped with a titanium or steel tip. The titanium or steel tip vibrates at an ultrasonic frequency of 40,000 Hz and is used to emulsify the lens material. 


Manual Small Incision Cataract Surgery (MSICS): 

This surgical technique evolved from the Extracapsular Cataract Extraction process which we cover below, and is a surgical process which uses a self-sealing scleral tunnel wound to express the entire lens from the eye.


Extracapsular Cataract Extraction (ECCE): 

Extracapsular Cataract Extraction is the removal of most of the natural lens while leaving the posterior capsule intact to allow for the implantation of an intraocular lens.


Intracapsular Cataract Extraction (ICCE):

Intracapsular Cataract Extraction is the surgical process which is used to remove the lens of the eye, as well as the surrounding lens capsule, in one piece. This procedure is rarely performed today. 


Femtosecond Laser-assisted Cataract Surgery:

This surgical procedure uses an Ophthalmological Laser to perform Cataract Surgery. It has the same visual, refractive and safety benefits as manual phacoemulsification.



This surgical procedure is a form of Intracapsular Cataract Extraction which is used to freeze the lens with a cryogenic substance such as liquid nitrogen. Not generally used today, this was the preferred form of cataract extraction between the late 1960s and the early 1980s.

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