The small incision cataract surgery has fascinated ophthalmologists just as keyhole surgery for appendix removal. Credit for invention and first intraocular lens (IOL) implantation is given solely to Harold Ridley who performed the first IOL implantation on November 29, 1949, at the St. Thomas Hospital in London. Phacoemulsification has become the standard of care for cataract surgery in the indutrialized world and is rapidly gaining popularity in developing countries. In a survey carried out by David Leaming, among the American Society of Cataract and Refractive Surgery Surgeons, the number of cataract surgeons performing phacoemulsification has increased from 12% in 1985 to 97% in 1998. The turning point was 1990 and the main reasons were introduction of continuous curvilinear capsulorrhexis, hydrodissection and use of newer nucleus dividing techniques for safer phacoemulsification. At present, majority of the eye specialists in developing world perform large incision intracapsular and extracapsular surgery and phacoemulsification accounts for approximately 10% of cataract surgery. The pace of innovation seems to be accelerating in cataract surgery where, the ophthalmologists are refining their surgical techniques to optimize benefits to the patients. The evolution of technology from surgical technique to intraocular lens design has been amazing. The innovations in phaco surgery are in the field of surgical techniques, phacodynamics and in intraocular lens designs. Viscoelastic substances (ophthalmic viscoelastic device) play an important role in successful outcome of cataract surgery. Viscoelastic substances have proved to be useful adjuncts for extracapsular cataract surgery and phacoemulsification with intraocular lens implantation.