What Are the Different Types of Cataract Surgery?
Dr Leo Seo Wei
Senior Consultant Ophthalmologist
MBBS (NUS), MRCS (Edin), MMed (Ophth) (NUS), FRCS (Edin) (Ophth), FAMS (Ophth)
Cataracts are a prevalent eye problem in Singapore, affecting about 95% of individuals aged 70 and older. Characterised by the clouding of the eye's natural lens, cataracts cause blurry vision and can significantly impact daily activities. As the condition progresses, vision continues to worsen and can eventually lead to blindness. To effectively treat cataracts, ophthalmologists may perform cataract removal surgery.
Types of Cataract Surgery Available in Singapore
Cataract surgery is among the most commonly performed surgeries in Singapore, with an estimated 25,000 procedures yearly. This procedure permanently removes the clouded natural lens, replacing it with an artificial intraocular lens (IOL) to restore clear vision.
Several approaches may be used:
1. Phacoemulsification (Phaco)
Phacoemulsification (phaco) is the most common cataract removal method today. It is performed through a small incision, about 2–3mm long, through which the cataract is removed and a foldable intraocular lens (IOL) is then implanted.
This technique leaves a self-sealing wound, typically requiring no sutures, which means faster recovery, less discomfort, and minimal trauma to the eye. However, this approach may not be suitable for extremely dense cataracts, as they might not be effectively broken down by ultrasound energy.
2. Femtosecond Laser-Assisted Cataract Surgery (FLACS)
FLACS utilises a laser to soften and fragment the cloudy lens, replacing the traditional blade. This allows for greater accuracy and may require less ultrasound energy during cataract removal, potentially leading to faster healing. This technique is also beneficial for complex cases and can even correct astigmatism for improved vision after the procedure. However, FLACS may be more expensive than other cataract removal approaches.
3. Extracapsular Cataract Extraction (ECCE)
ECCE is a less frequently used method, typically reserved for exceptionally dense cataracts that cannot be effectively broken down by phacoemulsification. This procedure involves removing the lens in one piece through a larger incision that requires stitches. While effective for advanced cataracts, ECCE generally has a longer recovery time and a slightly higher risk of complications compared to phacoemulsification.
Choosing the Right Surgical Approach
Each cataract removal technique offers unique advantages, but the most ideal approach ultimately depends on several factors:
- Cataract Density and Type: The hardness and maturity of your cataract significantly influence the surgical method. For instance, phacoemulsification may not be suitable for extremely dense cataracts.
- Eye Anatomy: Your eye's specific anatomical features play a role in determining the safest and most effective technique.
- Desired Visual Outcomes & Lifestyle: Your personal vision goals and lifestyle needs will guide the choice of IOL and surgical method. For example, if you have astigmatism, FLACS may be suitable to correct your vision.
- Existing Eye Conditions: Other ocular conditions, such as glaucoma or retinal issues, can influence which surgical approach is most suitable.
Your ophthalmologist is in the best position to determine the right approach. With detailed assessments, they can recommend the method that offers you the best possible outcome. If you have cataracts, do not delay seeking medical attention to prevent vision loss.
In Singapore, Dr Leo Seo Wei is an ophthalmologist with extensive experience in cataract diagnosis and treatment. Committed to patient-centric care, her philosophy is to provide only safe, modern, and evidence-backed treatments, customising each plan to fit individual patient needs. Contact us today to schedule an appointment.