Cataract surgery is one of the most commonly performed surgical procedures in the world — and one of the most life-changing. When the natural lens becomes cloudy (cataract), it is removed and replaced with an artificial intraocular lens (IOL). The choice of IOL determines the quality of your vision for the rest of your life.
Dr Naren Shetty, Director and Head of Cataract & Refractive Surgery at Narayana Nethralaya, has performed over 27,000 cataract and refractive surgeries. He offers every category of premium IOL - monofocal, toric, trifocal, and extended depth of focus (EDOF) - and selects the right lens based on your eye anatomy, lifestyle, and visual goals.
27,000+
Cataract surgeries by Dr Naren Shetty
3 distances
Near, intermediate & far with trifocal IOL
< 30 min
Phacoemulsification procedure time
1- 2 days
Return to normal daily activities
Phacoemulsification - Modern Cataract Surgery
Modern cataract surgery uses phacoemulsification - ultrasound energy delivered through a 2- 3mm micro-incision to emulsify and aspirate the cloudy lens. The IOL is then injected through the same incision in a folded state and self-unfolds inside the eye. No stitches, no patch overnight.
Pre-operative biometry
IOL Master or Pentacam biometry measures axial length, keratometry, and anterior segment parameters to calculate the precise IOL power for your eye.
Topical anaesthesia
Anaesthetic drops numb the eye. No injection around the eye, no general anaesthesia. You remain awake and comfortable.
Micro-incision (2- 3mm)
A self-sealing incision is made at the corneal periphery. No blade contact with the visual axis.
Capsulorrhexis
A precise circular opening is made in the lens capsule - the bag that holds the lens. This is the most skill-dependent step.
Phacoemulsification
Ultrasound energy fragments the cloudy lens nucleus into tiny pieces, which are aspirated through the same probe. The lens capsule (bag) is preserved.
IOL implantation
The premium IOL is injected in a folded state through the micro-incision. It self-unfolds and is centred within the capsular bag.
Post-operative care
Medicated drops for 4- 6 weeks. Vision improves rapidly from Day 1. Full stabilisation in 4- 6 weeks.
Femtosecond Laser-Assisted Cataract Surgery (FLACS)
The most advanced cataract surgery technique uses a femtosecond laser to automate the most critical and difficult steps - resulting in greater precision and potentially better outcomes, especially with premium IOLs where centration and capsulorrhexis accuracy are critical.
Laser Capsulorrhexis
The circular opening in the lens capsule is made with laser precision - perfectly centred and perfectly round. Manual capsulorrhexis is technique-dependent; laser eliminates variability.
Laser Lens Fragmentation
The laser pre-softens and fragments the cataract nucleus before phaco, reducing the ultrasound energy needed and minimising collateral tissue stress.
Laser Corneal Incisions
All incisions including limbal relaxing incisions (for astigmatism) are made with sub-micron laser precision rather than a blade.
Better IOL Centration
Perfectly centred capsulorrhexis ensures premium multifocal and EDOF IOLs are optimally centred on the visual axis - critical for best optical performance.
Premium IOL Types - Which Is Right for You?
The IOL decision is the most important choice in cataract surgery. Here is a comprehensive breakdown of every lens category available at Narayana Nethralaya.
Monofocal IOL
StandardMonofocal IOLs provide excellent clarity at a single focal point - usually distance. They offer the best contrast sensitivity and lowest risk of optical side effects. Reading glasses will typically be required.
Available lenses:
Monofocal Plus / Enhanced Monofocal IOL
Extended RangeA newer category offering slightly extended depth of focus compared to standard monofocals, without the halos and glare risk of diffractive multifocals. A good intermediate option.
Available lenses:
Trifocal IOL
PremiumTrifocal IOLs use diffractive optics to simultaneously focus light at three distances. Most patients achieve complete spectacle independence for distance, computer work, and reading. Halos at night are the main trade-off - usually mild and adapt within weeks.
Available lenses:
EDOF (Extended Depth of Focus) IOL
Smooth RangeEDOF IOLs create an elongated focal range rather than discrete focal points. Excellent for distance and intermediate (computer screen) vision with significantly fewer halos than trifocal lenses. Near vision may require reading glasses in low light.
Available lenses:
Toric IOL
Astigmatism CorrectionToric IOLs have a cylindrical correction built into the lens optic, correcting corneal astigmatism that would otherwise blur distance vision. Available in monofocal, EDOF, and trifocal platforms. Rotational stability is critical - premium toric IOLs have <3° rotation.
Available lenses:
Light Adjustable Lens (LAL)
Adjustable After SurgeryThe LAL (RxSight) is a photosensitive silicone lens that can be fine-tuned with UV light treatments in the clinic after implantation - allowing the surgeon to optimise your prescription once healing is complete. The only IOL that allows post-surgical power adjustment.
Available lenses:
How to Choose the Right IOL
Dr Naren Shetty's IOL selection process is based on four pillars:
Your Lifestyle & Visual Demands
Do you read extensively? Work on a computer all day? Drive at night frequently? A trifocal may suit a reader; an EDOF may suit a night driver.
Your Eye Anatomy
Corneal topography, pupil size, axial length, and angle kappa determine which IOL will perform best. Some patients are poor trifocal candidates due to large angle kappa.
Existing Conditions
Macular degeneration, glaucoma, or prior refractive surgery may limit premium IOL options. A monofocal may be safer in these cases.
Tolerance for Trade-offs
All premium IOLs involve trade-offs. Trifocals give spectacle independence but mild halos. EDOF lenses give clean optics but may need reading glasses. Dr Shetty discusses these honestly before surgery.
Cost of Premium IOL Cataract Surgery in Bangalore (2025)
| IOL Category | Example Lenses | Cost (per eye) |
|---|---|---|
| Monofocal IOL | Alcon AcrySof, HOYA ViVien | ₹30,000 - ₹50,000 |
| Monofocal Plus / Enhanced | TECNIS Eyhance, Vivity mono | ₹55,000 - ₹80,000 |
| EDOF IOL | Alcon Vivity, AT LARA | ₹75,000 - ₹1,10,000 |
| Trifocal IOL | PanOptix, FineVision, AT LISA tri | ₹90,000 - ₹1,40,000 |
| Toric (any platform) | Any IOL + cylinder correction | +₹20,000 - ₹40,000 |
| FLACS (Laser-assisted) | Add-on to any above | +₹20,000 - ₹40,000 |
* Includes pre-operative biometry, IOL, surgery, and post-operative care. Final pricing confirmed at consultation.
Frequently Asked Questions - Premium IOL Cataract Surgery
What is the difference between a standard and premium IOL?+
A standard monofocal IOL corrects vision at one distance (usually distance). Premium IOLs - trifocal, EDOF, toric - correct vision at multiple distances and/or correct astigmatism, significantly reducing or eliminating the need for glasses after surgery.
Will I need glasses after premium IOL surgery?+
Most trifocal IOL patients achieve complete spectacle independence. EDOF patients typically need reading glasses for very fine print. Monofocal patients need reading glasses. The result depends on the lens selected, your eye anatomy, and post-operative healing.
Are halos and glare common with trifocal IOLs?+
Mild halos at night are common initially with diffractive trifocal IOLs. Most patients neuroadapt within 4- 12 weeks. Modern trifocal designs (PanOptix, FineVision) have significantly reduced halos compared to older multifocal designs.
Can I have cataract surgery if I've had LASIK before?+
Yes, but IOL power calculation is more complex after LASIK. Dr Naren Shetty uses advanced formulas (Barrett True-K, Kane post-refractive) and intraoperative aberrometry to ensure accurate IOL selection.
How soon can I drive after cataract surgery?+
Most patients can drive within 2- 5 days of surgery once vision stabilises. You should not drive until Dr Shetty has reviewed your vision post-operatively and confirmed it is safe.
Can cataracts come back after surgery?+
The cataract itself cannot return - the natural lens is permanently replaced. However, the lens capsule (bag) can sometimes become cloudy (posterior capsule opacification / PCO). This is treated with a quick, painless YAG laser procedure in clinic.
Is cataract surgery done on both eyes on the same day?+
At Narayana Nethralaya, cataract surgery is typically performed on one eye at a time, with the second eye done 1- 2 weeks later after confirming the first eye has healed well.