The short answer
Phaco and SICS are both modern, proven ways to remove a cataract and put in a clear artificial lens. Phaco breaks the cataract up with ultrasound and removes it through a very small cut, usually with no stitches. SICS removes the lens whole through a slightly larger, self-sealing tunnel, and is often chosen for very dense, advanced cataracts. In good hands both give good sight; the surgeon's skill and a proper assessment matter more than the name of the method.
Book cataract surgery, from ₦420,000Medically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
What the two operations have in common
Both are done under local anaesthetic, usually as a day case. In both, the cloudy natural lens is taken out and a clear artificial lens, called an intraocular lens, is placed in the same spot. Both are a long way from the old operation that removed the lens through a large cut and left people in thick glasses. Neither is couching, the traditional practice of pushing the lens back into the eye, which can blind an eye for good.
Phaco: small cut, ultrasound
In phacoemulsification the surgeon makes a cut of a few millimetres, uses an ultrasound probe to break the lens into tiny pieces, and suctions them out. A foldable lens is then slid in. The cut usually seals without stitches. Recovery of sight is often quick and there tends to be less astigmatism from the wound.
Phaco needs costly equipment and a lot of training. It is harder in a very hard, white cataract, because more energy is needed to break it up, and that can stress the clear front window of the eye.
SICS: a tunnel, no machine
Manual small incision cataract surgery makes a slightly longer tunnel in the white of the eye and slides the lens out whole. The tunnel is shaped to seal itself. It does not depend on a phaco machine, and it copes well with dense, mature cataracts, which are common in people who have waited a long time.
There may be a little more astigmatism and slightly slower settling than after phaco, so your glasses prescription afterwards can differ. Your surgeon will tell you what to expect for your eye.
How the choice is usually made
Your surgeon weighs a few things:
- How dense the cataract is. Very advanced cataracts are often better suited to SICS
- The health of the front of the eye, including the cornea
- Other conditions such as glaucoma, diabetes or a small pupil
- Which method the surgeon does most often and most safely
- Your work and whether you want the quickest possible return to sharp sight
What it costs on Mezo
Standard monofocal lens, biometry and both post-operative reviews included.
Common questions
Is phaco always better than SICS?
No. Phaco has advantages in many eyes, but for a very dense cataract SICS can be the safer choice. The best operation is the one your surgeon judges right for your eye and does well.
Which one is used on Mezo?
The surgeon decides after examining you and tells you before you agree. Ask them which method they plan and why. The standard case on Mezo is priced as a phaco case with biometry and both reviews included.
Will I need stitches?
Usually not with phaco, and often not with SICS, because the tunnel seals itself. Some eyes need a stitch, and your surgeon will tell you if so.
How much does cataract surgery cost?
On Mezo cataract surgery starts from ₦420,000 per eye, with a written all-in quote after the assessment. HMO cover is accepted on eligible plans, and the desk files the prior authorisation for you before the day.
The procedures
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Get one written price for your cataract operation
Tell us the operation and whether you will pay cash or through your HMO. Asking is free. A coordinator calls you back, and the written all-in quote follows the surgeon's assessment, so you know the full price before you commit.
Get a fixed surgery quoteSources and further reading
The guidelines and patient information this page is checked against. Care in Nigeria follows the same evidence; what differs is the price and where it is done.
- Cataracts in adults: management. National Institute for Health and Care Excellence (NICE). Clinical guideline.
- What are cataracts?. American Academy of Ophthalmology. Patient information.
- World report on vision. World Health Organization. Official publication.
Links last checked 23 October 2026.
Medical disclaimer: This guide is general information and does not replace advice from your own doctor. Where your centre's instructions differ from this guide, follow theirs.