A cataract can make everyday tasks feel harder: reading signs, driving at night, recognising faces, or enjoying a favourite book. When the cloudy natural lens begins to interfere with daily life, cataract surgery may be considered. Micro Incision Cataract Surgery (MICS) uses a very small surgical opening to remove the cloudy lens and place a clear intraocular lens (IOL). The exact technique, incision size and lens choice depend on the eye and the surgeon’s assessment. Here is a practical overview of what patients may expect when discussing MICS with Dr. Sonam Angmo Garg.

Before surgery: assessment and planning

The first step is a comprehensive eye examination. Your ophthalmologist checks the cataract, cornea, retina, eye pressure and general eye health. Measurements of the eye help calculate the IOL power. Tell the team about previous eye procedures, allergies, medicines, diabetes, blood pressure and any difficulty lying flat. If you have retinal disease or another eye condition, it may affect the plan or the vision expected after surgery. Your surgeon will explain the likely benefits, limitations and alternatives, and answer questions about lens options.

You will receive instructions about medicines, meals and arrival time. Follow the clinic’s own guidance; do not stop prescribed medicines unless your doctor tells you to. Arrange for someone to take you home, since you should not drive immediately after the procedure.

During the procedure: the usual sequence

1. 1. Preparing the eye. The team confirms which eye is being treated and uses anaesthetic drops or another appropriate local anaesthetic to numb it. Drops may also widen the pupil. The skin around the eye is cleaned, and a sterile drape is placed. You are generally awake and may notice lights, movement or gentle pressure, but should not expect to see surgical detail.
   2. Making a small incision. The surgeon creates a small opening in the cornea. MICS describes techniques that use a particularly small incision; the precise size varies with the instruments, IOL and individual case. Small incisions often self-seal, though the surgeon decides whether any closure is needed.
   3. Removing the cloudy lens. In common phacoemulsification techniques, ultrasound energy breaks the cataract into smaller pieces, which are gently removed through the incision. The thin capsule that held the natural lens is preserved to support the implant.
   4. Placing the IOL. A folded artificial lens is inserted through the opening and positioned inside the capsule. The surgeon checks its position and the eye’s stability before finishing. Cataract surgery is usually performed as day surgery, but timing and steps differ by patient and clinic.

After surgery: healing and follow-up

Your vision may be hazy at first and can fluctuate while the eye settles. You will be given drops and instructions for protecting the eye, washing, sleeping and resuming activities. Use drops exactly as directed and attend all follow-up visits. Avoid rubbing or pressing the eye. Call the clinic promptly for increasing pain, worsening vision, marked redness, flashes, a sudden shower of floaters or a curtain-like shadow. These symptoms need timely assessment rather than waiting for a routine appointment.

Frequently asked questions

1. 1. Does MICS hurt? Anaesthesia is used to keep the eye comfortable. Some pressure or awareness of light may occur. Tell the team if you feel pain or anxiety.
   2.  How long does the operation take? The procedure itself is commonly brief, but preparation and recovery make the visit longer. Your clinic can advise on its schedule.
   3.  Will I stop wearing glasses? That depends on the IOL selected and your eyes. Many patients still need glasses for some tasks; discuss realistic goals before surgery.

For information about the clinic’s procedure, read MICS Cataract Surgery.