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Phacoemulsification Surgery for Cataract
Phacoemulsification Surgery at Grewal Eye Institute


A cataract is a cloudiness or opacity of the eye's natural clear lens. It obstructs the passage of light to the retina (Parda) of the eye and impairs vision. When the lens develops cloudiness to the point that it impairs vision, it is called Cataract. It is like looking through a frosted glass.


Progressive and painless blurring of vision is the commonest symptom. The blurring of vision may be more marked in bright light. Brightness and contrast of the image decrease in early cataract. Some individuals experience glare while driving at night. Colors may become less distinct. Later on the vision deteriorates and interferes in day to day activities. Seeing multiple moons at night also suggests cataract. Pain, itching, redness or watering of eye are not symptoms of cataract. Cataract usually develops in both eyes, but may progress at different rates.
Decreased Contrast

Decreased Contrast

Multiple Moons

Multiple Moons

Difficulty to Recognize People

Difficulty to Recognize People

Difficulty in Reading

Difficulty in Reading

Difficulty in Driving

Difficulty in Driving

Halos Around Lights

'Halos' Around Lights


It is no stitch small incision cataract surgery. The incision is only 1.8mm - 2.8mm long. Phaco uses ultrasound energy to liquify lens and suck it out with a Titanium probe, vibrating forty thousand times a second. The minute (2.6mm or smaller) incision is self-sealed and needs no suture or stitch to close it. The patient will be back to normal activities within a few days, including attending office or even doing heavy manual work. The foldable IOL made of transparent silicone Or acrylic polymer to be inserted inside the eye in a fine tube and it unfolds to full size once inside the eye.

Toric IOLs

A significant proportion of the population has astigmatism (cylindrical refractive errors) that is not corrected with standard IOLs resulting in need for spectacles for both distance and near vision. With the availability of cutting edge technology it is possible today to implant such people with customized IOLs which have capability to correct the cylindrical errors as well. These IOLs are knows as TORIC IOLs and are available in both single focus and multifocal platforms. The use of these IOLs offers greater chances of spectacles free vision to the patient.

General FAQs

Who gets cataracts?
More than half the population over the age of 65 will have some cataract. It is likely to be said that everyone will develop a cataract if he/she live long enough.

Is cataract found only in older people?
Cataract usually develops with advancing age. About half of the population has a cataract by age 65, and nearly everyone over 75 has some cataract. Sometimes, it may be present at birth or may develop in childhood.

Is cataract inevitable?
Yes and no. If you live long enough, you will almost certainly develop cataract, because this is part of the normal aging process.

What are the different types of cataract?
  1. Age-related cataract: Most cataracts are related to aging.

  2. Congenital cataract: Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may not affect vision. If they do, they may need to be removed.

  3. Secondary cataract: Cataracts are more likely to develop in people who have certain other health problems, such as diabetes. Also, cataracts are sometimes linked to steroid use.

  4. Traumatic cataract: Cataracts can develop soon after an eye injury, or years later.
Can cataracts be prevented?
Currently there is no medical treatment to reverse or prevent the development of cataracts. Once they form, there is only one way to achieve clear vision again, and that is to physically remove the cataract from the eye.

Can I wait for the surgery after diagnosis of cataract?
It depends on quality of your vision. If the decrease in vision is interfering with your day to day social, personal or professional services, you should not wait. With good results it is not worth just managing with compromised vision.

Is surgery the only treatment for cataracts?
Yes. Surgery is the only option. Medicines can not cure. I am a diabetic. Can I go for lens implantation? Yes. IOLs are specially recommended for diabetic patients. However your diabetes should be adequately controlled.

How is a cataract removed?
A small incision is made into the eye. Ultrasonic energy is used to emulsify lens and suck it out through a tiny needle. An Intraocular Lens or IOL is inserted to replace the removed lens. Is cataract surgery effective? Cataract removal is one of the most common operations performed in the world today. It is also one of the safest and most effective. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

What are possible complications of cataract surgery?
As with any surgery, pain, infection, swelling and bleeding are possible, but very few patients have serious problems or complications. Your surgeon may prescribe medications for these effects. Retinal detachment also occurs in a few people. Be on the lookout for excessive pain, vision loss, or nausea, and report these symptoms to your eye surgeon immediately.

Pre-Operative FAQs

I am a farmer by profession. How many days after cataract surgery can I go to fields?
You can go to farm within a week. The lens is implanted / fitted inside the eye and is not affected by dusty environment.

What will happen if I choose not to have an operation?
Your cataract can progress and reach a stage where glaucoma may develop or may progress to a stage where suture-less surgery is not possible.

Do I have to wait for surgery till the cataract becomes mature?
No. Early surgery gives you best vision, quick recovery and least complications. You get to enjoy best vision much earlier.

How long is the life of intraocular lens, Is there any need to replace it again?
The lens stays with you for the rest of life. There is no need to clean, maintain or replace the lens after it has been implanted.

When can I fly after cataract surgery?
You can fly the next day. Do discuss your travel plans with the doctor.

What other treatment options are available?
There is really no treatment except surgery.

If I ever required can the IOL be replaced?
Although it's unlikely but an implanted IOL can be replaced with a different one if necessary. It is called IOL exchange. Talk to your surgeon to learn how he would handle this situation.

I have cataracts in both eyes. Will the doctor treat both at the same time?
Avoid surgery of both eyes on the same day. Give some gap between surgery of both the eyes. When can I get the second eye operated? It will depend on the vision of the second eye. Second eye surgery can be planned within next 3-5 days.

Can I develop cataract again?
Once a cataract has been removed, it cannot develop again. However, over time, patients may notice that their vision has once again become hazy. This condition, which can occur with any type of IOL, is known as secondary cataract, or posterior capsular opacification (PCO). Secondary cataracts can be easily treated with a simple laser procedure performed in OPD.

What happens before surgery?
Your doctor will do some tests to measure the curve of the cornea and the size and shape of your eye. Also, doctors may ask you not to eat or drink anything after midnight or in the morning of your surgery.

Operative FAQs

How long will I stay at GEI on the day of surgery?
You total stay at GEI will be for about three hours.

Can I eat before surgery in the morning?
We recommend you not to eat.

Can I bring food from home?
Yes, if you are diabetic. Light refreshments are available at our canteen.

How many attendants can accompany me?
Please do not bring more than two attendants with you.

Does cataract surgery hurt?
Thanks to numbing drops and medications to help you relax, the surgical procedure involves minimal discomfort.

Is there any pain during the surgery?
You do not experience any pain during surgery.

How long it takes for the surgery?
The surgery takes about eight to ten minutes. You stay inside the operation room for 30 to 40 minutes.

Can I bring my other medicines?
Yes. You must keep taking any medicines you have been prescribed for any other disease.

What happens during surgery?
You will be given eye drops to dilate your pupil before surgery. The area around your eye will be washed and cleansed. The operation usually lasts less than ten minutes and is painless. After the operation, a patch will be placed over your eye and you will rest for a while. Since you will not be able to drive, make sure you accompany someone.

Post-Operative FAQs

What all I can do the next day?
You can go for a walk next day. Depending on your comfort and confidence, you can drive, exercise and even go to your office.

When will I be able to go to gym or do heavy exercise?
It is recommended to avoid these for fifteen days. Light exercise can be started within a few days.

When can I wash my face after surgery?
Avoid washing your face for two days. You can shave, shower or have head bath after that.

What protection and care do I need for my operated eye?
You should not touch your eyes for one day. There is no need for dark glasses. No additional protection is required at night. Do not miss the medicines prescribed to you.

How many times will I have to visit the hospital?
You need two visits. The first visit is one day after surgery and the second is two weeks after surgery.

Are there any diet restrictions after the surgery?
No. You can resume your normal diet after the surgery. The diabetics should strictly adhere to their recommended diet.

Can I use hair color or eye make-up?
It is better to avoid hair dye and makeup for two weeks.

How long I need to take medication after surgery?
Oral tablets are required for a total of 5 days and eye drops need to be instilled for four to five weeks.

Do I need to wear dark glasses after the surgery?
No. The lenses we use have built in UV filters.

When can I watch TV or do work on my computer?
It depends on your comfort levels. There is no restriction on watching TV.

Do I need to use spectacles after the surgery?
Yes. Spectacles are prescribed for two weeks. You will get good functional vision after cataract surgery without glasses. Glasses may be required for distance in some cases. Reading or near-work glasses will be required by all cases. You do not need thick glasses. Even cases with Multifocal IOL may have little near vision number and may need glasses after surgery.

When can I start reading or writing?
You can start as soon as you feel comfortable. Please remember that the operated eye will get prescription for glasses after two weeks.

Can I wear color contact lenses after Cataract surgery?
Yes. Only after all the eye drops have been stopped.

When can I cook food or be involved in house hold work?
Any time after two days.

Can I touch my eyes after surgery?
Please avoid touching your eyes for a week.

Can I swim after surgery?
Yes. Avoid swimming for first two weeks after surgery.

Can I splash water into my eyes after the surgery?
Yes, after fifteen days with eyes closed.

Can I play golf after the surgery?
You should be able to tee off after one week.

How long after surgery I'll be able to see again?
Every patient and his eyes behaves differently, but most patients typically see well enough to drive within a day after surgery. Ask your doctor how quickly he or she expects you to recover.

How long until I can return to normal activities?
Most patients can resume basic activities like reading and watching TV the day after surgery, and can usually return to work within two to seven days. Doctors typically advise against any strenuous activity for two or more weeks. Results vary by patients; therefore ask your doctor what's best for you.

Will I be able to drive at night after surgery?
Your ability to drive at night should be significantly improved once your cataract is removed. Patients with Multifocal IOLs may notice a ring of light around headlights and other light sources. These halos are typically mild, rarely bothersome and tend to diminish with time.

Are there any precautions I should take after surgery?
Every patient is different, so be sure to ask your doctor for advice on caring for your eyes after the procedure. Oftens though, your doctor will simply ask you to refrain from rubbing your eye or engaging in any strenuous activity for a few weeks after surgery.

Who should I call if I have a problem after surgery?
Consult your doctor immediately if you have any issues particularly if you experience decreased vision or pain.

If I have problem in the evening on the day I got operated what should I do?
If you feel any pain or decrease in vision, contact our 24 hour helpline 098153 91339.

I feel a sensation as if foreign body in my eye after surgery. Should I be concerned?
Usually patients feel some sensation which settles down within a few days after surgery. Rarely, some patients may experience foreign body sensation for 2-3 weeks. The surgeon usually prescribes lubricant eye drops which take care of the temporary sensation.

Do I have to stop blood thinners such as Coumadin, Aspirin or Pravix etc.?
No. You can continue these drugs before surgery.

I felt the surgery on my second eye was different than on the first, why?
The surgery remains the same for any eye. But, many patients may feel some difference due to multiple factors.

How do I feel after surgery?
It's normal to feel itching and mild discomfort for a while. Some fluid discharge is also common, and your eye may be sensitive to light and touch.

Myths and Facts

Cataract is the only cause of painless progressive loss of vision. You need not consult doctor till vision is completely lost.
Truth: There are many diseases of retina (Parda) and glaucoma (Kala Motia) where the symptoms are similar to those of cataract. In these conditions if treatment is not done in time the vision will permanently lost and it may never be restored. Any diminution of vision calls for an immediate consultation. Don’t make your own diagnosis.
There are too many precautions for diet and rest after surgery.
Truth: There are no restriction after surgery. you do not need bed rest. You can go for evening walk the same day. The patient can have normal diet without any restrictions.
I am too old to get a lens implant.
Truth: Old age is not a contraindication for lens implant. Phacoemulsification & IOL surgery takes less time than the conventional cataract surgery and does not cause any stress. It saves the elderly patient from the trouble of wearing thick glasses.
I can not get lens implant because I live in dusty surroundings.
Truth: The lens is fitted inside the eye and is not exposed. Therefore it is very safe for people doing manual labor or working in dusty environment.
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