The earliest records are from the Bible as well as early Hindu records. Early cataract surgery was developed by the Indian surgeon, Sushruta (6th century BCE). The Indian tradition of cataract surgery was performed with a special tool called the Jabamukhi Salaka, a curved needle used to loosen the lens and push the cataract out of the field of vision.[ The eye would later be soaked with warm butter and then bandaged.Though this method was successful, Sushruta cautioned that it should only be used when necessary. Greek physicians and philosophers traveled to India where these surgeries were performed by physicians. The removal of cataract by surgery was also introduced into China from India.

The first references to cataract and its treatment in Ancient Rome are found in 29 AD in De Medicinae, the work of the Latin encyclopedist Aulus Cornelius Celsus.The Romans were pioneers in the health arena - particularly in the area of eye care.
The Iraqi ophthalmologist Ammar ibn Ali of Mosul performed the first extraction of cataracts through suction. He invented a hollow metallic syringe hypodermic needle, which he applied through the sclerotic and extracted the cataracts using suction. In his Choice of Eye Diseases, written in circa 1000, he wrote of his invention of the hypodermic needle and how he discovered the technique of cataract extraction while experimenting with it on a patient.

Rajah Serfoji II (1777-1832), a deposed prince of the Maratha dynasty in the south city of Thanjavur in Tamil Nadu is also believed to have maintained impeccable records of the ocular conditions of his patients. Records show cataract surgeries being performed during his rule in his kingdom. In his preserved text one can find ophthalmic terminology like "cornea, conjunctiva, capsule of the lens and posterior chamber. "

When a cataract is sufficiently developed to be removed by surgery, the most effective and common treatment is to make an incision (capsulotomy) into the capsule of the cloudy lens in order to surgically remove the lens. There are two types of eye surgery that can be used to remove cataracts: extra-capsular (extracapsular cataract extraction, or ECCE) and intra-capsular (intracapsular cataract extraction, or ICCE).

Extra-capsular (ECCE) surgery consists of removing the lens but leaving the majority of the lens capsule intact. High frequency sound waves (phacoemulsification) are sometimes used to break up the lens before extraction.
Intra-capsular (ICCE) surgery involves removing the entire lens of the eye, including the lens capsule, but it is rarely performed in modern practice.
In either extra-capsular surgery or intra-capsular surgery, the cataractous lens is removed and replaced with a plastic lens (an intraocular lens implant) which stays in the eye permanently.

Cataract operations are usually performed using a local anaesthetic and the patient is allowed to go home the same day. Recent improvements in intraocular technology now allow cataract patients to choose a multifocal lens to create a visual environment in which they are less dependent on glasses. Under some medical systems multifocal lenses cost extra. Traditional intraocular lenses are monofocal.

Complications are possible after cataract surgery, including endophthalmitis, posterior capsular opacification and retinal
detachment. In ICCE there is the issue of the Jack in the box phenomenon[clarification needed] where the patient has to wear aphakic glasses - alternatives include contact lenses but these can prove to be high maintenance, particularly in dusty areas.