Traditional vs Femto Cataract Surgery

Which One Is Right for You?

Two Effective Paths to Clearer Vision

If you’ve been diagnosed with a cataract, you’ve likely heard there are two main surgical options: traditional cataract surgery and Femto (femtosecond laser-assisted) cataract surgery. Both are safe and effective, but differ in technique, precision, cost, and suitability. So, how do you know which one is right for you?

In this blog, we’ll break down the differences between these two procedures to help you make an informed decision about your eye health.

What Is Traditional Cataract Surgery?

Traditional cataract surgery is performed using a micro-surgical blade and ultrasound technology. It is the most commonly used technique worldwide and has a long-standing track record for safety and success.

Steps include:

1. A small manual incision in the cornea
2. A handheld tool creates an opening in the lens capsule
3. Ultrasound (phacoemulsification) breaks up the cloudy lens
4. The fragments are removed and replaced with an intraocular lens (IOL)

This method is fast, reliable, and widely covered by medical aid.

What Is Femto Cataract Surgery?

Femto Cataract Surgery uses a femtosecond laser to replace the manual steps of the traditional approach. It offers bladeless, computer-guided incisions and laser precision in opening the lens capsule and softening the cataract for removal.

Steps include:

1. Digital eye mapping for personalisation
2. Laser-created corneal incision and capsulotomy
3. Laser fragmentation of the lens
4. Ultrasound is used (minimally) to remove fragments
5. IOL insertion and alignment, often for premium lenses

The result is a highly customised procedure with improved accuracy and outcomes.

Comparison: Traditional vs Femto Cataract Surgery

Feature	Traditional Surgery	Femto (Laser) Surgery
Incision method	Manual blade	Bladeless laser
Capsule opening	Manually created	Precisely laser-cut
Lens fragmentation	Ultrasound only	Pre-softened by laser
Precision & consistency	Surgeon-dependent	Image-guided & laser-precise
Ideal for premium IOLs	Yes, with limitations	Excellent pairing
Astigmatism correction	Manual incisions	Laser-optimised
Surgery duration	15–30 minutes	20–30 minutes
Recovery time	Fast	Often faster due to less trauma
Cost	Covered by most medical aids	Co-payment usually required

Benefits of Traditional Cataract Surgery

• Proven and widely available
• Short operation time and recovery
• Effective for standard cataracts
• Lower out-of-pocket costs
• Excellent results with monofocal IOLs
  

Traditional surgery remains a reliable option for patients with uncomplicated cataracts without needing advanced lens correction.

Benefits of Femto Cataract Surgery

• Increased precision and safety
• Improved IOL alignment and positioning
• Better outcomes for multifocal and toric lenses
• Less energy is needed inside the eye, meaning less inflammation
• Customised to your unique eye anatomy

Femto is especially beneficial if you’re investing in premium vision correction or want the latest technology for peace of mind.

Who Should Consider Femto Cataract Surgery?

Femto may be the better choice for you if:

• You want enhanced precision and visual outcomes
• You have astigmatism and want it corrected during surgery
• You’re choosing premium intraocular lenses (e.g. multifocal, EDOF, or toric)
• You value technology-driven procedures
• You want a bladeless, customised approach

It’s also worth discussing Femto if you’ve had previous eye surgery or conditions that require a more controlled procedure.

Cost Considerations

• Traditional surgery is generally covered by medical aids without co-payments (if done at a designated facility with standard lenses).
• Femto surgery usually involves a co-payment ranging from R3,000 to R15,000 per eye, depending on the clinic and the type of lens chosen.

While Femto is a higher investment, many patients feel that the cost justifies the improved accuracy, faster healing, and long-term vision benefits.

Choosing the Right Lens: It Matters

If you’re going with a monofocal IOL and are satisfied with using reading glasses afterwards, traditional surgery is often enough.

Femto’s precision is ideal if you’re choosing multifocal or toric lenses, which require exact alignment for best results.

Talk to Your Eye Surgeon

Every eye is different. The right type of cataract surgery depends on:

• The health of your eyes
• Your lifestyle and visual goals
• Whether you have astigmatism
• Your budget and medical aid coverage

An experienced surgeon will evaluate your eye anatomy, explain your options, and recommend the best approach for your needs.