Cataract Surgery in Alexandria: Phacoemulsification and Personalised Lens Implants
Cataract surgery replaces the eye's clouded natural lens with a clear artificial intraocular lens (IOL). Prof. Dr. Amr Said performs conventional phacoemulsification (phaco) cataract surgery and, after detailed measurements, helps each patient choose between monofocal, enhanced monofocal, toric, EDOF and multifocal/trifocal lenses — including eyes with previous LASIK or PRK, keratoconus or an irregular cornea. The pace and level of visual improvement vary from patient to patient.
Last reviewed and updated: 6 November 2026
Quick answers At a glance
Which technique is used?
Phacoemulsification: the cloudy lens is broken up with ultrasound through a small incision and replaced with a folding IOL. Femtosecond laser-assisted cataract surgery is not offered at the clinic.
Which lens is best?
No lens type is best for everyone. The choice depends on your measurements, cornea, retina, ocular surface and daily visual priorities, and is made after an examination.
Can astigmatism be corrected?
Regular corneal astigmatism can often be reduced with a toric IOL. Irregular astigmatism, such as in keratoconus, needs a different, individual plan.
Will I need glasses afterwards?
Many patients need glasses for some tasks. Toric, EDOF and multifocal designs may reduce dependence on glasses, but none can guarantee freedom from them.
Cataract surgery as an opportunity for visual planning
Modern cataract surgery is not simply the removal of an opaque lens. It is an opportunity to plan visual rehabilitation according to each patient's eye measurements, corneal condition, refractive needs and lifestyle. Prof. Dr. Amr Said provides phacoemulsification cataract surgery with individualised selection of modern intraocular lens options.
Prof. Dr. Amr Said is Assistant Professor of Ophthalmology, Faculty of Medicine, Alexandria University. His clinical work focuses on corneal and refractive surgery, keratoconus management and cataract surgery. This combination matters when the cornea is not typical, for example after LASIK or PRK, in keratoconus or with an irregular corneal surface. See his professional profile and published research.
About the technique: the clinic performs phacoemulsification (ultrasound) cataract surgery. Femtosecond laser-assisted cataract surgery is not currently offered. This is separate from the femtosecond lasers used for corneal vision correction such as Femto-LASIK or SMILE, which is a different procedure.
What is cataract?
A cataract is a clouding of the eye's natural crystalline lens, which sits behind the iris and focuses light onto the retina. As the lens becomes cloudy, light is scattered and blocked, and vision becomes blurred, dim or glary. Cataract is not a film on the surface of the eye, and it cannot be removed with drops or glasses.
Common symptoms
- Gradually blurred or "foggy" vision that glasses no longer fully correct.
- Glare and halos around lights, especially when driving at night.
- Colours that look faded or yellowish.
- Frequent changes in glasses prescription, sometimes with a new short-sightedness.
- Occasionally, double vision in one eye.
Causes and risk factors
Ageing is by far the most common cause. Cataract can also develop earlier with diabetes, long-term steroid use, eye injury, previous eye surgery, inflammation, high myopia, smoking and prolonged sun exposure. Some children are born with cataract, which needs separate paediatric assessment.
When is cataract surgery indicated?
Surgery is usually recommended when the cataract reduces vision enough to interfere with your daily life, such as reading, driving, work or hobbies, and updated glasses no longer give adequate vision. The decision is shared between you and your surgeon. There is no fixed number on the eye chart that applies to everyone.
- Difficulty with driving, especially glare at night.
- Difficulty reading, recognising faces or working on screens.
- A medical reason, for example a lens that narrows the drainage angle and raises eye pressure, or a cataract that prevents the retina from being examined or treated in diabetes.
- A very dense (mature) cataract, which can make surgery more complex if it is left for a long time.
Is it necessary to wait for the cataract to "ripen"? No. This is an outdated idea. With modern phacoemulsification, surgery can be planned when symptoms justify it. Waiting until a cataract is very advanced may make surgery technically harder.
What is modern phacoemulsification?
Phacoemulsification ("phaco") is the standard modern technique for cataract removal. Through a small incision at the edge of the cornea, an ultrasound probe breaks the cloudy lens into tiny pieces and gently removes them. A foldable intraocular lens is then placed inside the natural lens capsule, which is left in place to support it.
- Small, usually stitch-free incisions that self-seal.
- Local anaesthesia, usually numbing drops, sometimes with additional local anaesthetic. You stay awake but comfortable.
- Day-case surgery: you go home the same day.
- Lens choice and power calculation are planned beforehand, which is where refractive cataract planning makes the difference.
How is cataract surgery performed?
- Preparation: the eye is confirmed and marked, the pupil is dilated, and the planned lens and target are checked again. For toric lenses, reference marks may be used to guide alignment.
- Anaesthesia: anaesthetic drops numb the eye, and the skin around it is cleaned with antiseptic.
- Micro-incisions: small entry wounds are made at the edge of the cornea.
- Capsulorhexis: a round opening is made in the front of the lens capsule.
- Phacoemulsification: the cloudy lens is broken up with ultrasound and removed.
- IOL implantation: the folded lens is injected into the capsule, where it unfolds. A toric lens is rotated to the planned axis.
- Completion: the incisions are checked, medication is applied and the eye is protected. You rest briefly and go home with an escort.
Cataract surgery duration varies depending on the cataract and individual eye condition. Allow additional time for preparation and recovery at the centre.
What are the available IOL categories?
Intraocular lenses fall into five main categories, each with several designs. The specific lens is chosen for your eye after assessment. This page explains the categories and does not recommend any particular brand; which designs are suitable and available for you is confirmed at consultation.
Monofocal IOL
- Optical principle
- A single focal point: the lens is set for one chosen distance.
- Intended visual range
- Usually distance. A near target, or monovision (one eye set for distance and the other slightly near), is possible after careful discussion and sometimes a trial.
- Potential benefits
- High image quality and contrast at the chosen distance, with a well-established, predictable profile.
- Limitations
- Glasses are generally needed for other distances, and for significant astigmatism unless a toric version is used.
- Possible visual disturbances
- Generally the lowest rate of halos and glare among the categories, although no lens is entirely free of them.
- Typical patient considerations
- Suits most eyes, including those with macular disease, glaucoma or an irregular cornea, and patients who prioritise contrast and night driving.
Enhanced monofocal IOL
- Optical principle
- A monofocal lens with a modified optical profile that slightly extends the range of focus, without splitting light into separate foci.
- Intended visual range
- Distance, with some functional intermediate vision depending on the lens design.
- Potential benefits
- A modest gain for intermediate tasks such as a car dashboard or a computer at arm's length.
- Limitations
- Reading glasses are usually still needed. "Enhanced monofocal" is not a single standard, so the effect varies by design.
- Possible visual disturbances
- In many designs, a profile close to a standard monofocal; some patients still notice mild glare or halos.
- Typical patient considerations
- Patients who want slightly more intermediate range without multifocal trade-offs, including some eyes that are not suited to multifocal optics.
Toric IOL
- Optical principle
- Adds cylindrical power to correct selected regular corneal astigmatism. Available in monofocal and some extended-range or multifocal designs.
- Intended visual range
- Determined by the base design it is combined with (monofocal, EDOF or multifocal).
- Potential benefits
- Sharper uncorrected vision when regular corneal astigmatism is significant.
- Limitations
- Suitability depends on accurate, repeatable corneal measurements, including the back corneal surface where measured, and precise axis alignment. Rotation after surgery reduces the effect and may need repositioning.
- Possible visual disturbances
- Those of the base design; residual astigmatism can cause blur or ghosting.
- Typical patient considerations
- Regular, stable astigmatism. Markedly irregular corneas, such as advanced keratoconus or corneal scarring, are usually unsuitable.
EDOF IOL (Extended Depth of Focus)
- Optical principle
- Creates an elongated focal range rather than a single sharp focal point.
- Intended visual range
- Distance and functional intermediate vision, such as computer screens. Near vision is often limited.
- Potential benefits
- May reduce dependence on glasses for intermediate tasks.
- Limitations
- Fine print and prolonged near work often still need reading glasses, and performance varies considerably between designs.
- Possible visual disturbances
- Halos, glare, starbursts (dysphotopsias) or reduced contrast can occur; their frequency and severity vary by design and between patients.
- Typical patient considerations
- Healthy macula and optic nerve, regular cornea, stable ocular surface and realistic expectations.
Multifocal & trifocal IOL
- Optical principle
- Divides light between two (bifocal) or three (trifocal) focal points for distance, intermediate and near.
- Intended visual range
- Distance, intermediate and near.
- Potential benefits
- May reduce dependence on glasses across several distances in suitable eyes.
- Limitations
- Spectacle independence is not guaranteed: some light is always out of focus, and the brain needs time to adapt (neuroadaptation).
- Possible visual disturbances
- Halos and glare around lights, especially at night, and reduced contrast sensitivity, which can affect night driving. Most people adapt over weeks to months, but not everyone does.
- Typical patient considerations
- Healthy retina and optic nerve, regular cornea, stable ocular surface, often no significant previous corneal surgery, and acceptance of night-time effects.
IOL comparison table
| IOL category | Main visual target | Potential advantages | Limitations | Spectacle expectations | Patient-selection considerations |
|---|---|---|---|---|---|
| Monofocal | One distance (usually far) | Sharp image at the target distance, high contrast, fewest halos, well-established predictability | No useful range beyond the target distance | Glasses for near (or distance), and for astigmatism unless toric | Suits most eyes, including those with coexisting eye disease or irregular corneas |
| Enhanced monofocal | Distance, with some intermediate | Slightly wider range than standard monofocal, with a similar side-effect profile in many designs | Modest effect, which varies by design | Reading glasses usually needed | Patients who want a little more intermediate range without multifocal trade-offs |
| Toric (any design) | Corrects regular corneal astigmatism, combined with the chosen focus design | Sharper uncorrected vision when astigmatism is significant and regular | Needs precise axis alignment, and rotation reduces the effect | Depends on the base design (monofocal, EDOF or multifocal) | Regular, stable astigmatism; not for markedly irregular corneas |
| EDOF | Distance and intermediate | Continuous range from distance to intermediate in many designs; night-time symptoms vary by design | Near vision may be limited; some halos or glare possible | Light reading glasses often needed for small print | Healthy macula, regular cornea, realistic expectations |
| Multifocal / trifocal | Distance, intermediate and near | Greatest potential reduction in spectacle dependence | Halos and glare, reduced contrast, need for neuroadaptation | Many patients rarely need glasses, but this is not guaranteed | Healthy retina and optic nerve, regular cornea, stable ocular surface, acceptance of night-time effects |
No category is universally best. Each design trades range of focus against image quality and night-time side effects. Your lens is chosen individually, after examination and a discussion of your expectations. No intraocular lens can guarantee spectacle independence or perfect vision.
For a longer patient guide to lens categories, see types of modern intraocular lenses (Arabic). For a detailed comparison of all five categories, suitability and halos, see advanced IOL selection in cataract surgery.
Not sure which lens category could suit your eyes? The answer depends on your measurements and examination. Send your questions or previous test results on WhatsApp to arrange an assessment.
Ask about lens options on WhatsAppHow is the appropriate IOL selected?
Choosing a lens is a medical and personal decision. It brings together what the examination shows about your eye with what you want from your vision.
Factors that guide the choice
- Eye measurements: axial length, corneal power and anterior chamber depth from optical biometry.
- Corneal shape and regularity: amount and type of astigmatism, and higher-order irregularities on topography or tomography.
- Ocular surface: dry eye and meibomian gland disease can distort measurements and reduce quality of vision.
- Retina and optic nerve: macular disease, diabetic changes or glaucoma may favour a monofocal design.
- Previous surgery: LASIK, PRK, RK or corneal cross-linking change calculation methods and lens suitability.
- Keratoconus or an irregular cornea: may limit the suitability of toric and multifocal lenses and calls for adjusted calculation methods.
- Occupation, lifestyle and priorities: work requirements, night driving, reading, computer use, sport and how you feel about possible halos.
- Expectations about glasses: whether you are comfortable wearing glasses for some tasks, which helps match the lens to realistic goals.
- General and eye medical history: for example diabetes, previous eye inflammation or injury, a lazy eye, and medicines such as tamsulosin and similar alpha-blockers, which can influence surgical planning.
- Cost: categories differ in cost, which is discussed openly at consultation.
Why corneal expertise matters: in keratoconus, after LASIK or PRK, and with corneal scarring or irregular astigmatism, the cornea — rather than the cataract — is often the main factor limiting predictability. Planning these eyes benefits from experience in corneal and refractive surgery, including interpreting corneal tomography and judging when a toric or extended-range lens is, or is not, appropriate.
The selection pathway
- Full examination and measurements.
- Treatment of any ocular surface problem, and repeat measurements if needed.
- Discussion of your visual priorities and of the realistic options for your eye.
- Agreement on a lens category and a target refraction for each eye.
- IOL power calculation with modern formulas, using special methods for eyes with previous corneal surgery or keratoconus.
- After the first eye, the plan for the second eye is reviewed in light of the result.
An online quiz or an advertisement cannot choose your lens. The right option is decided only after an individual assessment.
What is refractive cataract surgery?
Refractive cataract surgery is an approach to cataract surgery that aims both to clear the vision and to reduce pre-existing refractive error, such as short-sightedness, long-sightedness, astigmatism and, in selected cases, presbyopia. It does this through precise measurements, an explicit refractive target, appropriate lens selection and careful surgical planning.
What it involves
- Distance and near visual targets: deciding whether each eye is set for distance, near or a blended range.
- Corneal astigmatism assessment: measuring its amount, axis and regularity, including the back corneal surface where measured.
- Toric IOL planning: calculating toric power and axis when astigmatism is regular and significant.
- Ocular surface optimisation: treating dry eye before final measurements, because an unstable tear film changes the readings.
- Optical biometry: precise measurement of eye length and anterior segment dimensions.
- IOL power calculations: modern formulas, with adjusted methods after corneal refractive surgery or in keratoconus.
- Expectations and limitations: a clear discussion of what is and is not achievable.
How does refractive cataract surgery differ from conventional cataract surgery?
Both use the same surgical technique, phacoemulsification, and carry broadly similar surgical risks. The difference lies in the planning and the goal. Conventional cataract surgery focuses mainly on restoring a clear lens, usually with a monofocal lens set for distance, and accepts that glasses will be needed for remaining tasks and any residual astigmatism. Refractive cataract surgery adds more detailed corneal and ocular surface assessment, explicit management of astigmatism, and consideration of extended-range or multifocal lenses where the eye is suitable.
Even with careful planning, small residual refractive errors can occur because measurements and formulas have limits. This is particularly so after previous corneal surgery or in irregular corneas. Some patients need glasses for certain tasks, and a few may benefit from a later enhancement.
Important: cataract surgery is offered for a cataract that affects vision, or for another medical indication. It is not done simply to correct a refractive error in an otherwise healthy eye. For people without cataract, options such as laser vision correction or implantable contact lenses (ICL) are usually considered first. Lens replacement without cataract is a separate decision with its own risks.
Cataract with corneal astigmatism: can surgery correct it?
Often, yes, provided the astigmatism is regular. Regular corneal astigmatism of a meaningful amount can usually be reduced with a toric IOL. If it is left uncorrected, patients may need glasses for clear vision even with a premium lens.
What makes toric correction accurate
- Repeatable keratometry on a healthy, stable tear film.
- Consideration of posterior corneal astigmatism, the back surface of the cornea, which can change the total astigmatism.
- Planning for the small astigmatism the incision itself may induce.
- Accurate axis marking and alignment during surgery, and a follow-up check that the lens has not rotated.
When toric IOLs may not be suitable
In irregular astigmatism, for example moderate to advanced keratoconus, corneal scars or decentred previous laser treatment, the cornea cannot be fully corrected by a lens. Rigid or scleral contact lenses may still be needed after surgery. Very small amounts of astigmatism may not need a toric lens. In some cases, residual astigmatism after surgery can be refined later with laser vision correction. Read more in cataract with irregular astigmatism.
Cataract surgery after LASIK or PRK
Laser vision correction reshapes the front of the cornea. Standard IOL formulas were designed for unoperated corneas, so after LASIK, PRK or SMILE they can misjudge the corneal power. The result can be an unexpected prescription, a "refractive surprise", typically long-sighted after previous myopic correction.
- Bring your old records if available: the prescription before laser surgery and the original corneal measurements help some calculation methods.
- Several dedicated formulas are compared, such as those collected in the ASCRS post-refractive calculator, and a target is chosen that reduces the risk of a long-sighted result.
- Corneal tomography checks the treatment zone, its centration and the posterior cornea.
- Lens choice: some post-LASIK eyes do well with monofocal, toric or extended-range lenses. Multifocal designs need extra caution because the treated cornea may already add optical aberrations.
Outcomes after previous refractive surgery are less predictable than in unoperated eyes. Glasses or a later enhancement may be needed, and not every post-LASIK eye is suitable for a premium IOL.
Detailed articles: cataract surgery after LASIK or PRK · IOL calculation after corneal refractive surgery.
Cataract surgery in keratoconus and irregular corneas
In keratoconus, the cornea is thinner, steeper and irregular. This creates particular challenges for cataract surgery planning.
- Measurement reliability: corneal power readings can be unreliable or vary between devices, especially with steep cones.
- Formula error: standard formulas tend to leave advanced keratoconus eyes more long-sighted than intended. Keratoconus-adjusted methods and conservative targets may be used.
- Contact lens wearers: rigid or scleral lenses mould the cornea, so they are usually stopped for a period before final measurements. Many patients still need them after surgery for best vision.
- Toric IOLs: considered only in selected mild, stable cases where central astigmatism is reasonably regular.
- Multifocal IOLs: usually avoided because the irregular cornea already reduces image quality.
- Corneal health: stability, any previous cross-linking or ring segments, corneal scarring and the corneal endothelium are all assessed.
Because the cornea is the main source of the problem, cataract surgery in keratoconus benefits from corneal expertise. Explore the dedicated articles below, or start with cataract surgery in keratoconus and keratoconus treatment.
Cataract with retinal or macular disease
Cataract often coexists with other eye conditions, particularly with age or diabetes. The health of the retina — especially the macula, the centre of sharp vision — and of the optic nerve influences how much vision can improve, which lens is sensible and how the eye is cared for around surgery.
- Diabetic retinopathy and diabetic macular oedema: the retina is examined and macular OCT is performed when indicated. Active disease may need treatment and stabilisation before or around cataract surgery, coordinated with a retina specialist where needed.
- Age-related macular degeneration, epiretinal membrane or macular hole: these can limit final sharpness and contrast. A monofocal or enhanced monofocal lens is often preferred to multifocal designs, which split light and may reduce contrast further.
- Glaucoma and optic nerve disease: the state of the optic nerve and visual field can affect lens choice and aftercare, including eye-pressure monitoring.
- Previous retinal surgery or high myopia: these may change measurements, surgical planning and risks, which are discussed individually.
When another eye condition is present, cataract surgery can still be worthwhile, but the improvement may be limited by that condition. This is discussed openly before surgery.
Related: OCT and OCT angiography of the retina and optic nerve (Arabic) · diabetes and the retina (Arabic).
Preoperative evaluation and biometry
Good outcomes start with good measurements. Your assessment may include the tests below. Not every test is needed for every patient, and not every device is located at every branch. When you book, you will be told which tests you need and where they are performed. Optical biometry is essential for calculating lens power, while corneal tomography, macular OCT or ocular surface tests are added when your examination calls for them.
| Assessment | Purpose | How it can influence the IOL choice |
|---|---|---|
| Visual acuity and refraction | Measures current vision and prescription | Shows how much the cataract limits vision and guides the refractive target |
| Slit-lamp examination | Examines the cornea, iris, lens and capsule support | Detects corneal disease, weak zonules or other findings that change the surgical plan |
| Optical biometry | Measures eye length and anterior segment dimensions | The core input for IOL power calculation |
| Keratometry | Measures corneal power and astigmatism | Determines whether a toric IOL is needed, and at what power and axis |
| Corneal topography / tomography | Maps the front and, with tomography, the back corneal surface and thickness | Separates regular from irregular astigmatism, and identifies keratoconus or previous laser treatment |
| Ocular surface evaluation | Assesses tear film and eyelid glands | An unstable surface is treated first, because it distorts measurements and quality of vision |
| Macular OCT (when indicated) | Cross-sectional scan of the central retina | Macular disease may favour a monofocal lens rather than a multifocal one |
| Dilated retinal examination | Examines the retina and optic nerve | Identifies diabetic or other retinal disease and glaucoma that affect prognosis and lens choice |
| IOL calculation and target planning | Combines measurements with modern formulas | Sets lens power and the target for each eye, with special methods after LASIK/PRK or in keratoconus |
Learn more about these investigations: cataract diagnosis and pre-operative tests (Arabic) · diagnostic imaging: Pentacam and OCT (Arabic) · advanced corneal diagnostics · macular and retinal OCT (Arabic) · dry eye assessment and treatment.
Already have previous scans or reports? Bring them to your appointment or mention them on WhatsApp — they help decide which tests are still needed.
Book a pre-operative assessmentYour cataract surgery journey, step by step
- Initial consultation and visual assessment: your symptoms, daily visual needs, general health and medicines are reviewed, and vision and refraction are measured.
- Cataract examination and other eye conditions: the cataract is assessed at the slit lamp, and the cornea, ocular surface, eye pressure, retina and optic nerve are examined, because they influence both the plan and the expected result.
- Biometry and additional tests when indicated: optical biometry to calculate lens power, with corneal tomography, macular OCT or ocular surface tests added when your examination calls for them.
- Surgical plan and lens options: the findings are explained, the lens categories suitable for your eye are discussed with their benefits, limitations and costs, and a refractive target is agreed for each eye.
- Phacoemulsification and IOL implantation: a day-case procedure under local anaesthesia. Its duration varies with the cataract and the individual eye.
- Postoperative instructions and follow-up: eye drops, eye protection and scheduled follow-up visits. Vision often improves progressively, at a pace that differs between patients, and glasses are checked once the eye has settled.
Recovery and postoperative follow-up
Vision often improves progressively over the first days and weeks after surgery, and it is normal for vision to be blurry or glary at first. The pace and final level of visual recovery vary between patients and depend on the lens chosen and on the health of the cornea, retina and optic nerve.
- Eye drops: antibiotic and anti-inflammatory drops are used for several weeks, exactly as prescribed.
- Follow-up visits: typically the next day, then at intervals over the following weeks. Your schedule depends on your eye.
- Protecting the eye: avoid rubbing or pressing on it, wear the shield as advised, and avoid swimming and dusty environments for the period your surgeon recommends.
- Daily activities: reading, walking and watching television are usually fine early on. Ask before resuming driving, heavy exercise or work.
- New glasses: any final prescription is usually checked a few weeks after surgery, once the eye has settled.
- Adaptation: with EDOF and multifocal lenses, the brain may take weeks to months to adapt to the new optics.
Contact the clinic urgently if you have increasing pain, worsening vision, increasing redness, or new flashes, many floaters or a shadow in your vision.
Risks, complications and realistic expectations
Cataract surgery is one of the most common and successful operations in medicine, but no surgery is risk-free. Your personal risks are discussed before you consent.
Common and usually temporary
- Grittiness, dryness, light sensitivity or mild inflammation.
- A temporary rise in eye pressure.
Later effects
- Posterior capsule opacification ("secondary cataract"): clouding of the capsule behind the lens, which can develop months or years later. It is usually treated with a quick outpatient YAG laser.
- A residual refractive error that needs glasses or, occasionally, an enhancement.
- Rotation of a toric lens, which may need repositioning.
- Halos, glare or other visual phenomena, which are more likely with multifocal designs.
Less common but important
- Swelling of the central retina (cystoid macular oedema) or of the cornea.
- A tear in the lens capsule, or lens fragments that need further surgery.
- Retinal detachment.
- Infection inside the eye (endophthalmitis). This is rare but serious and needs urgent treatment.
Realistic expectations: the final quality of vision also depends on the health of the cornea, retina and optic nerve. If another eye condition is present, vision may improve less than hoped, even after a technically successful operation.
Cataract and IOL research
Prof. Dr. Amr Said is a co-author of peer-reviewed research on cataract and lens surgery. The publications below are listed exactly as published and were verified against their DOI and PubMed records.
Comparison between refractive outcomes of femtosecond laser-assisted cataract surgery and standard phacoemulsification
Comparison between Refractive Outcome of Primary Piggyback Intraocular Lens versus Secondary Lens Iris Claw Lens in Posterior Microphthalmos
Please note: research comparing femtosecond laser-assisted cataract surgery with conventional phacoemulsification is cited here to show academic engagement. It does not mean the laser-assisted technique is offered. The clinic currently performs phacoemulsification.
See all verified publications on the Research & Scientific Publications page.
Questions patients ask
When should cataract surgery be performed?
When the cataract affects your daily activities and glasses no longer help enough, or when there is a medical reason, such as raised eye pressure caused by the lens or the need to monitor the retina. You do not need to wait for the cataract to “ripen”.
Is phacoemulsification painful?
Surgery is performed under local anaesthesia, usually numbing drops, so most patients feel pressure or light touch rather than pain. Mild grittiness or discomfort for a day or two afterwards is common and usually settles with the prescribed drops.
What is the difference between monofocal and multifocal IOLs?
A monofocal lens focuses clearly at one distance, usually far, so reading glasses are typically needed. A multifocal or trifocal lens divides light between several distances to reduce dependence on glasses. In exchange, it carries a higher chance of halos, glare and reduced contrast.
Which IOL is suitable for astigmatism?
Regular corneal astigmatism of a meaningful amount can often be corrected with a toric IOL, which is available in monofocal and some extended-range designs. Irregular astigmatism, as in keratoconus or corneal scarring, usually cannot be fully corrected with a toric lens.
What is an EDOF lens?
An extended depth of focus (EDOF) lens creates an elongated focal range, aiming for good distance and intermediate vision, such as a computer screen. Reading fine print may still need light glasses, and some designs can cause mild halos.
Are trifocal lenses suitable for everyone?
No. Trifocal lenses need a healthy retina and optic nerve, a regular cornea and a stable ocular surface, as well as acceptance of possible halos at night. People with macular disease, advanced glaucoma, keratoconus or some previous corneal surgery are often better served by other lens types.
Can cataract surgery reduce dependence on glasses?
Yes, it often can, through careful choice of lens power, toric correction for astigmatism, and extended-range or multifocal designs in suitable eyes. However, no lens can guarantee freedom from glasses, and many patients still use them for some tasks.
Can I have cataract surgery after LASIK?
Yes. Cataract surgery after LASIK or PRK is routinely performed, but the lens power calculation is more complex because the cornea was reshaped. Dedicated formulas are used and, if you have them, your old laser records help. A small residual prescription is more likely than in unoperated eyes.
What happens if I have keratoconus and cataract?
Cataract surgery can be performed, but the irregular cornea makes measurements and formulas less reliable. Toric lenses suit only selected stable, more regular cases, and multifocal lenses are usually avoided. Many patients still need rigid or scleral contact lenses afterwards for their best vision.
How long does recovery take?
Recovery varies between patients. Vision often improves progressively over days to weeks, and many daily activities can be resumed early on your surgeon's advice. Eye drops are used for several weeks, and any glasses prescription is checked once vision has stabilised. Adaptation to multifocal or EDOF optics can take longer.
Can cataract return after surgery?
The cataract itself cannot return, because the natural lens has been removed. However, the capsule behind the new lens can become cloudy months or years later (posterior capsule opacification). This is usually treated with a quick outpatient YAG laser.
What are the possible complications?
Most are minor and temporary, such as dryness, inflammation or a short-lived rise in pressure. Less common problems include residual prescription, lens rotation, macular swelling, capsule tear and retinal detachment. Serious infection is rare. Your individual risks are discussed before surgery.
How do I choose the appropriate IOL?
The choice is made with your surgeon after examination. It combines your eye measurements, corneal shape, ocular surface, retinal health and previous surgery with your lifestyle, priorities and expectations. No online recommendation can replace this individual assessment.
Medically reviewed by: Prof. Dr. Amr Said — Assistant Professor of Ophthalmology, Faculty of Medicine, Alexandria University; consultant in corneal and refractive surgery, keratoconus management and cataract surgery.
Professional profile · Surgeon profile (Arabic) · Research & publications
Last reviewed and updated: 6 November 2026
This information is for patient education and is not a diagnosis or a recommendation of any specific lens. The intraocular lens is chosen after a personal examination, measurements and a discussion of your needs. The images on this page are AI-generated educational illustrations created for this website; they do not show the clinic, the doctor, real patients or actual results.
Scientific references
Published sources for further reading. This page is for education and does not replace a medical examination.
- Miller KM, Oetting TA, Tweeten JP, et al. Cataract in the Adult Eye Preferred Practice Pattern. Ophthalmology. 2022;129(1):P1–P126. doi.org/10.1016/j.ophtha.2021.10.006
- de Silva SR, Evans JR, Kirthi V, Ziaei M, Leyland M. Multifocal versus monofocal intraocular lenses after cataract extraction. Cochrane Database Syst Rev. 2016;12:CD003169. doi.org/10.1002/14651858.CD003169.pub4
- Kessel L, Andresen J, Tendal B, Erngaard D, Flesner P, Hjortdal J. Toric intraocular lenses in the correction of astigmatism during cataract surgery: a systematic review and meta-analysis. Ophthalmology. 2016;123(2):275–286. doi.org/10.1016/j.ophtha.2015.10.002
- Visser N, Bauer NJ, Nuijts RM. Toric intraocular lenses: historical overview, patient selection, IOL calculation, surgical techniques, clinical outcomes, and complications. J Cataract Refract Surg. 2013;39(4):624–637. doi.org/10.1016/j.jcrs.2013.02.020
- Kohnen T, Suryakumar R. Extended depth-of-focus technology in intraocular lenses. J Cataract Refract Surg. 2020;46(2):298–304. doi.org/10.1097/j.jcrs.0000000000000109
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