Cataract Surgery
in 2026
A quick, painless, and very safe procedure that restores clear vision within a few days.
Phacoemulsification: the gold standard technique in 2026
The reference surgical technique
Phacoemulsification is used in more than 98% of cataract operations in France. It involves fragmenting the opacified lens using ultrasound through a corneal micro-incision of approximately 2 mm, then aspirating the debris and placing a foldable intraocular lens into the capsular bag.
Rapid visual recovery
This technique has gradually replaced conventional extracapsular extraction thanks to its major advantages: faster healing, lower risk of induced astigmatism, and visual recovery within 24 to 72 hours.
The preoperative consultation
Before any procedure, a thorough preoperative consultation is essential. It includes several complementary examinations whose results determine the success of the surgery.
Laser interferometry measurement of axial length, keratometry, and anterior chamber depth. These data are used in calculation formulas to determine the exact power of the intraocular lens.
Mapping of the corneal surface. Essential for detecting irregular astigmatism (early keratoconus) and guiding the choice of toric or multifocal lens.
Cross-sectional imaging of the macula to rule out retinal pathology (AMD, epiretinal membrane, macular hole) that could limit postoperative visual recovery.
Assessment of corneal endothelial cell density. A density below 1,000 cells/mm² requires an adapted surgical technique to preserve the cornea.
Evaluation of the optic nerve, peripheral retina, and macula following pupillary dilation. Detects any associated pathologies to be treated before or after cataract surgery.
Mandatory pre-anesthetic medical assessment, even for topical anesthesia in an outpatient setting. Review of medical history and medications (particularly anticoagulants and antiplatelet agents).
Surgical procedure, step by step
Preparation and setup
The patient arrives having fasted for 6 hours. Pupillary dilation is achieved with mydriatic eye drops over 30 to 60 minutes. Conjunctival disinfection with 5% povidone-iodine is performed before entering the operating room.
Topical anesthesia with eye drops
Instillation of anesthetic eye drops. No injections, no general anesthesia in the vast majority of cases. The procedure is completely painless. The patient remains conscious, can speak to the surgeon, and perceives light without seeing the instruments.
Corneal micro-incisions
A main incision of 2.2 mm is made at the corneoscleral limbus. A paracentesis of 1 mm allows the introduction of auxiliary instruments. These incisions generally do not require sutures.
Capsulorhexis and hydromaneuvers
A continuous curvilinear capsulorhexis of approximately 5.5 mm in diameter is created in the anterior lens capsule. Hydrodissection and hydrodelineation then mobilize the lens nucleus to facilitate its aspiration.
Lens phacoemulsification
The ultrasound probe fragments and aspirates the nucleus using various techniques. The cortical material is removed by irrigation-aspiration.
Intraocular lens implantation
The foldable lens is injected into the capsular bag using an injector. It unfolds spontaneously, centered by its haptics within the bag. No sutures are required in the vast majority of cases. The lens is permanent and never needs to be replaced.
End of procedure and verification
Verification of wound integrity and lens centration. Intracameral antibiotic injection at the end of the procedure. Placement of a protective eye shield.
Total procedure duration: 8 minutes on average with Dr Julien Gozlan
Both eyes are operated on separately, typically one week apart.
Postoperative course and visual recovery
Recovery after cataract surgery is rapid. The vast majority of patients regain functional vision as early as the day after the procedure.
Day of surgery
Return home 2 hours after the procedure. Mild discomfort (foreign body sensation), tearing, and blurred vision are normal and transient. The protective eye shield is kept on until the following morning.
Postoperative check-up
Follow-up appointment the next day. The eye shield is removed and the ocular status is assessed. Vision is often already significantly improved. Postoperative treatment begins, with anti-inflammatory eye drops instilled 4 times daily for 1 month.
First week
Vision continues to improve and gradually stabilizes. Driving is permitted once visual acuity is sufficient. Sedentary professional activities may be resumed from day 2.
Stabilization and final optical prescription
Refraction stabilizes definitively and final glasses can be prescribed. In the case of a multifocal or EDOF lens, a neuroadaptation period of 3 months is normal before achieving maximum visual quality.
Risks and possible complications
Although cataract surgery is one of the safest procedures in medicine, it is not without risks. Informed consent requires that patients be fully aware of these risks. Dr. Gozlan systematically discusses them during the preoperative consultation.
Warning signs to watch for after surgery: painful redness of the operated eye, sudden loss of vision, or severe pain in the days following the procedure require emergency ophthalmologic evaluation — do not wait for the next scheduled appointment.
References & medical sources
- Haute Autorité de Santé (HAS). Chirurgie de la cataracte chez l'adulte — technique de phacoémulsification. Paris : HAS ; 2023.
- Agence Nationale d'Appui à la Performance (ANAP). Chirurgie ambulatoire de la cataracte : organisation et sécurité. Paris : ANAP ; 2022.
- Jaycock PD, et al. The Cataract National Dataset electronic multi-centre audit of 55 567 operations. Eye (Lond). 2009;23(1):32–39.
- Riaz Y, Mehta JS, Wormald R, et al. Surgical interventions for age-related cataract. Cochrane Database Syst Rev. 2006;(4):CD001323. doi:10.1002/14651858.CD001323.pub2
- Lundström M, Barry P, Henry Y, Rosen P, Stenevi U. Evidence-based guidelines for cataract surgery: guidelines based on data in the EUREQUO database. J Cataract Refract Surg. 2012;38(6):1086–1093.
- Liu YC, Wilkins M, Kim T, Malyugin B, Mehta JS. Cataracts. Lancet. 2017;390(10094):600–612. doi:10.1016/S0140-6736(17)30544-5