Modern cataract surgery can be performed in many ways using many different techniques. But in a vast majority of the cases, the doctor will use phacoemulsification to remove the eye's natural crystalline lens.

Depending on the type of replacement lens (or the condition of the cataract itself), your doctor will perform one of two procedures:

• Phacoemulsification
• Extracapsular surgery

Phacoemulsification (phaco) is the most common technique used today and the one we'll focus on here. For more information about these two types of procedures, see What is Cataract Surgery.

"Phaco"

First your doctor will make a very small incision in the eye, probably no larger than an eighth of an inch. He or she then will insert a thin instrument about the size of a pen tip to break up and remove the cloudy lens. Once the natural lens is removed, your doctor will replace it with an intraocular lens (IOL). The lens will be rolled up, inserted through the same incision, unrolled and set into its permanent position.

In some cases, your doctor may use a more rigid plastic lens and a slightly longer incision may be necessary. If so, you may need a stitch or two.

Alternatives

Phaco isn't appropriate for every situation, in which case your doctor will probably perform one of two alternatives:

Extracapsular surgery. This procedure is used for extremely dense or rigid lenses and requires a larger incision and stitches.

Intracapsular surgery. This extremely rare procedure involves removing both the lens and the capsule, generally when the lens has dislocated because of injury or disease.