PURPOSE. To evaluate the clinical effectiveness of combined mechanical trabecular peeling and phacoemulsification (PE) in patients with primary open-angle glaucoma (POAG) and complicated cataract. METHODS. The study included 72 patients (72 eyes) with POAG and complicated cataract (46 women, 26 men). Early stage POAG was present in 52 (72.2%) eyes, and moderate stage POAG in 20 (27.7%) eyes. Patients were divided into two groups. In the main group (37 patients, 37 eyes), subjects underwent mechanical trabecular peeling combined with phacoemulsification and intraocular lens (IOL) implantation. The control group (35 patients, 35 eyes) underwent isolated phacoemulsification with IOL implantation. Baseline intraocular pressure (IOP) measured by Maklakov tonometry was 23 [19; 24] mm Hg in the main group and 23 [21.0; 25.0] mm Hg in the control group (p=0.553). The number of hypotensive medications used preoperatively was 2 [0; 4] in the main group and 2 [0; 3] in the control group (p=0.135). The follow-up period was 12 months. RESULTS. At 12 months, IOP in the main group was 18.0 [18.0; 20.0] mm Hg with complete discontinuation of hypotensive therapy. In the control group, IOP was 20.0 [19.5; 22.5] mm Hg, with additional hypotensive therapy required in 9% of cases. The reduction in IOP from baseline was 15.37% in the main group and 11.46% in the control group (p=0.031). A significant difference between groups was observed in the ease of outflow coefficient (p=0.007). CONCLUSION. The developed combined technique of phacoemulsification with mechanical trabecular peeling results in a 15.37% reduction in IOP from baseline at 12 months postoperatively, exceeding the hypotensive effect of isolated PE. The method is associated with a minimal risk of complications and may be recommended for the treatment of patients with early and moderate POAG and complicated cataract.

Background/Objectives: Glaucoma is a leading cause of irreversible blindness, and lowering intraocular pressure (IOP) is the only proven strategy to slow disease progression. The Preserflo® Microshunt (PMS) is a minimally invasive subconjunctival drainage device used to treat uncontrolled glaucoma. Given that cataracts and glaucoma often coexist, this study aimed to compare the 12-month efficacy and safety of PMS implanted as a standalone procedure versus combined with phacoemulsification (PCE). Methods: This single-center retrospective case–control study included 104 eyes (26 PMS + PCE; 78 standalone PMS) from patients treated between 2019 and 2023. Controls were matched 3:1 to cases on sex, age, glaucoma severity, baseline IOP, and number of prior glaucoma surgeries. Success at 12 months was defined as absolute (IOP ≤ 21 mmHg without medications) or qualified (IOP ≤ 21 mmHg with the same or fewer medications). Secondary outcomes included changes in IOP, medication burden, and safety profiles. Results: At 12 months, absolute success was achieved in 23.1% of the PMS + PCE group versus 43.6% in the standalone PMS group (p = 0.13). However, the Kaplan–Meier survival probability of absolute success was significantly higher for standalone PMS (75.2% vs. 40.2%, p = 0.0028). Qualified success rates were comparable (53.9% vs. 70.5%, p = 0.30). Both groups showed similar reductions in mean IOP and medication counts. Although safety profiles were comparable, the mean time to first bleb revision (p = 0.031) and first needling (p = 0.015) was significantly shorter in the combined group. Conclusions: Both standalone and combined PMS procedures are effective and safe in achieving sustained IOP reduction. Although standalone implantation appears to be associated with higher medication-free success rates, combined surgery remains a reasonable option for patients with coexisting cataract, despite a tendency toward earlier bleb fibrosis likely related to the inflammatory response induced by PCE.

Glaucoma filtering surgery combined with phacoemulsification in the era of new aqueous humor filtration devices: A systematic review.

ABSTRACTObjective:To evaluate and compare the clinical outcomes of phacoemulsification (PE) combined with trabeculectomy (TB) versus PE combined with goniosynechialysis (GSL) in managing primary angle-closure glaucoma (PACG) coexisting with cataract.Methodology:This clinical research was designed as a retrospective study, including 71 patients with PACG and cataract who underwent surgical treatment at Zibo Center Hospital between October 2023 and May 2025. Among them, 37 patients (37 eyes) underwent PE and intraocular lens implantation combined with TB (PE+TB group), and 34 patients (34 eyes) underwent PE and intraocular lens implantation combined with goniosynechialysis (PE+GSL group). Patients were followed up for 12 weeks after surgery to assess intraocular pressure (IOP), best-corrected visual acuity (BCVA), central anterior chamber depth (CACD), corneal endothelial cell counts (ECCs), and the incidence of postoperative complications.Results:After surgery, IOP, BCVA, CACD, and ECCs improved significantly from baseline in both groups. However, between-group comparison showed a statistically significant difference only in IOP, which was lower in the PE+TB group than in the PE+GSL group (P<0.05), whereas BCVA, CACD, and ECCs were comparable between groups (all P>0.05). During postoperative follow-up, the incidence of complications in the PE+GSL group was significantly lower than that in the PE+TB group (P<0.05).Conclusions:PE combined with either TB or GSL has its own advantages in the treatment of PACG with cataract: PE+TB results in lower IOP, while PE+GSL leads to fewer complications.

To assess the efficacy and safety of goniotomy (GT) and gonioscopy-assisted transluminal trabeculotomy (GATT) with or without phacoemulsification (PEI) for exfoliation glaucoma (XFG). Searches were conducted in PubMed, Scopus, Embase, Ovid, and the Web of Science. Two independent reviewers performed study selection, data extraction, and quality assessment. The primary outcomes were the reduction in intraocular pressure (IOP) and the number of antiglaucoma medications (AGMs) at 1, 6, and 12 months postoperatively. Safety was assessed by the incidence of complications. Fourteen studies involving 624 eyes were included. The GATT ± PEI group showed significant IOP reductions of 1.96 mmHg (p < 0.01), 2.17 mmHg (p < 0.001), and 2.07 mmHg (p < 0.001) at 1, 6, and 12 months, respectively, with corresponding AGM reductions of 3.28 (p < 0.001), 2.87 (p = 0.003), and 2.54 (p = 0.011). The GT + PEI group demonstrated IOP reductions of 1.95 (p < 0.001), 2.00 (p = 0.040), and 2.13 mmHg (p = 0.013), with AGM reductions of 1.07, 0.96, and 0.96 (all p < 0.001). For standalone procedures, GT significantly reduced AGMs at all timepoints (all p < 0.001) and IOP at 1 and 6 months (both p = 0.002), while standalone GATT significantly reduced IOP only at 1 month (2.39 mmHg, p < 0.001) and AGMs at 6 and 12 months (both p < 0.001). The most common complications were anterior chamber hemorrhage (47.6%) and IOP spike (17.0%). This meta-analysis demonstrates that GT and GATT, particularly when combined with phacoemulsification, are safe and effective in reducing IOP and medication burden in patients with XFG. The evidence for sustained IOP lowering with standalone GATT remains limited, suggesting that combined surgery may offer more reliable long-term pressure control, especially for patients with concurrent cataract. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420251072295, identifier CRD420251072295.

Introduction: This study aimed to assess the impact of early vitrectomy on visual outcomes 1 month after surgery in patients with open ocular trauma. Methods: A historical cohort study analyzed 180 eyes from patients who underwent primary vitrectomy between 2017 and 2023. Data collected included the Birmingham Eye Trauma Terminology for injury assessment, the Ocular Trauma Score (OTS) for clinical findings, and visual acuity measured on the logMAR scale. Visual outcomes were compared between early surgery (within 4 days) and delayed surgery (after 4 days) using a linear mixed-effects model with a random effect for the surgeries performed. Results: Most cases had an OTS of 1 and underwent pars plana vitrectomy (PPV) and phacoemulsification (PHACO). OTS 2 cases underwent PPV with PHACO and air tamponade, while OTS 3–4 cases involved additional tamponades. One month after surgery, OTS 2 eyes with early surgery showed significantly better visual outcomes (p = 0.003). There were no statistically significant differences in complications regarding the time of surgery. Conclusion: Early vitrectomy, particularly within 4 days of injury, seems to improve both functional and anatomical outcomes in patients with severe open ocular trauma, especially for OTS 2.

Aim: To compare the efficacy and safety of phacoemulsification (PHACOE) versus manual small-incision cataract surgery (PHACOA) at the Chad–China Friendship University Hospital Centre (CHU‑ATC) in N’Djamena, Chad. Study Design: A prospective, descriptive, cross-sectional study conducted over 6 months, from 1 February to 31 July 2025, at the CHU‑ATC. Methods: All patients aged ≥40 years with preoperative visual acuity &lt;3/10 who underwent either PHACOE or PHACOA, were followed for at least 30 days postoperatively, and provided informed consent were included. Traumatic, congenital and pathological cataracts, as well as cases with detectable ocular pathology (corneal opacity), were excluded from the study. Results: Among 332 cataract surgeries, 279 eyes from 261 patients (mean age 58.8 ± 16.4 years) met the inclusion criteria. Of these, 53.7% (n = 150) underwent PHACOE and 46.3% (n = 129) underwent PHACOA. Intraoperative complications occurred in 8.5% of PHACOE procedures versus 8.0% of PHACOA procedures (p = 0.420), with capsular rupture being the most frequent (8.5% vs 6.0%, respectively). On postoperative day 30, uncorrected visual acuity ≥3/10 was achieved in 86.0% of PHACOE eyes versus 77.3% of PHACOA eyes (p = 0.101). With optical correction, visual acuity ≥3/10 was obtained in 87.6% of PHACOE eyes versus 79.3% of PHACOA eyes (p = 0.086). The mean gain in visual acuity was 11.8 lines for PHACOE compared with 9.6 lines for PHACOA (p = 0.10). Conclusion: Phacoemulsification provided better visual recovery than manual small-incision cataract surgery, while both techniques showed low perioperative complication rates. PHACOE outcomes met WHO standards for postoperative visual results, and PHACOA outcomes approached these standards. Given its lower cost, PHACOA represents a viable alternative in resource-limited settings such as Chad.

Descemet's membrane detachment (DMD) is defined as the detachment of Descemet's membrane that occurs spontaneously or secondary to intraocular surgery. This review focuses on the characteristics and incidence of DMD following phacoemulsification and glaucoma surgery, and aims to compare DMD cases after phacoemulsification (PCE) and different types of glaucoma surgery in terms of incidence, risk factors, clinical manifestations, diagnosis and management strategies. The reported incidence of DMD after PCE ranges from 0 to 5%, and the complication is less frequently observed following glaucoma surgery. Patients with DMD may be asymptomatic or present with severe visual impairment caused by corneal edema, which is associated with the size and location of the detachment. The management of DMD varies according to the primary surgical procedure (PCE or glaucoma surgery), as well as case-specific factors including visual acuity, corneal clarity, and the size and location of the detachment. Longitudinal observational studies are warranted to investigate the underlying cellular mechanisms of DMD. Retrospective studies can be conducted to clarify the incidence and identify all potential risk factors for DMD following glaucoma surgery. In addition, it is crucial to explore all possible risk factors to reduce and prevent this complication.

Introduction: Coloboma, a congenital defect resulting from the incomplete closure of the embryonal fissure, often affects the inferonasal part of the fundus. It is frequently associated with cataracts, which are a leading treatable cause of visual impairment. However, cataract surgery in colobomatous eyes presents significant challenges due to anatomical anomalies such as microcornea, zonular instability, poor pupillary dilation and structural irregularities. Need of the study: Cataract development is common in eyes with coloboma and significantly impacts vision, causing blurry vision, glare sensitivity and difficulties with daily activities. Cataract surgery in these eyes poses unique challenges due to the underlying anatomical abnormalities. Understanding the predictors of outcomes and the safety of different surgical techniques is crucial for optimising care and improving visual outcomes for patients with coloboma. By identifying factors associated with better or worse results, surgeons can tailor their approach to each individual patient, reducing risks and enhancing the chances of successful visual rehabilitation. Aim: The aim of this study is to evaluate different cataract surgeries for eyes with colobomas, as well as the safety and outcome predictors of various surgical methods. Materials and Methods: This hospital-based prospective interventional study will be conducted at the Department of Ophthalmology, Acharya Vinobha Bhave Rural Hospital, Sawangi, Maharashtra, India, over two years (May 2024 - April 2026) with 34 patients. The study aims to evaluate the outcomes and safety of cataract surgery techniques, including Phacoemulsification (PE) and Manual Small Incision Cataract Surgery (M-SICS). The type of surgery will depend on the degree of microcornea, cataract hardness and zonular stability. Preoperative, intraoperative and postoperative assessments will include detailed ophthalmic evaluations, visual acuity measurements, grading of microcornea and monitoring for complications such as corneal edema, using standardised grading systems. Statistical analysis will be performed using Statistical Package for the Social Sciences (SPSS)-version 23 to identify predictors of surgical outcomes, with significance set at p&lt;0.05. The study seeks to improve surgical techniques, enhance patient safety and provide insights into counseling and risk stratification for individuals with coloboma-associated cataracts.

The extent of peripheral anterior synechiae and efficacy of combined phacoemulsification and goniosynechialysis in primary angle-closure glaucoma and cataracts: A multicenter prospective study.

Purpose: To compare postoperative outcomes of phacoemulsification (PHACO) and small-incision cataract surgery (SICS), with emphasis on visual acuity, blink rate, ocular surface health and biometric changes.Methods: A prospective study was conducted on 80 patients (40 PHACO, 40 SICS) with age-related cataracts. Preoperative and postoperative assessments at day one, week one, and 1.5 months included LogMAR visual acuity, blink rate, Schirmer’s test, tear breakup time (TBUT), keratometry (K1, K2), and axial length.Results: Mean visual acuity improved markedly (LogMAR 1.57 ± 0.87 to 0.37 ± 0.25, p<0.001). Blink rate reduced significantly (6.63 ± 5.03 to 2.91 ± 1.84/min, p<0.001), reflecting better ocular surface stability. TBUT showed a modest increase (5.34 ± 2.58 to 6.38 ± 4.66 s, p=0.023), significant in PHACO (p=0.013) but not in SICS (p=0.114). Schirmer’s values (p=0.124) did not show significant overall change, though subgroup analysis revealed PHACO was associated with reduced tear secretion. Both groups showed significant increases in corneal curvature and axial length by 1.5 months.Conclusion: Phacoemulsification provided faster and superior visual recovery but was associated with reduced tear secretion, whereas SICS preserved ocular surface comfort despite slower visual rehabilitation. Blink rate reduction and TBUT improvement emerged as simple, non-invasive indicators of postoperative ocular surface stability, supporting their incorporation into cataract surgery outcome assessment.

This study aimed to evaluate the impact of cataract phacoemulsification (PE) on keratometry in patients who had previously undergone non-penetrating deep sclerectomy (NPDS), using anterior segment optical segment coherence tomography (OCT). Methods: We analyzed four clinical cases of PE, two of which were performed with femtosecond laser assistance. Results: During the 12-month follow-up period after PE, no significant effect on keratometric parameters was observed, irrespective of the initial corneal status or the use of a femtosecond laser. OCT data likewise revealed no pronounced structural changes in the NPDS zone following PE.

PurposeThe purpose of the study is to compare postoperative changes in central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) using spectral-domain optical coherence tomography (SD-OCT) in diabetic and non-diabetic eyes and to assess the influence of glycemic status and surgical technique.MethodsThis prospective study included 130 eyes of 130 patients aged 50-70 years with senile cataract, comprising 65 diabetic eyes and 65 non-diabetic eyes. All underwent uneventful cataract surgery by either phacoemulsification (PHACO) or small-incision cataract surgery (SICS). Systemic parameters-fasting blood sugar (FBS), postprandial blood sugar (PPBS), and glycated hemoglobin (HbA1c)-along with detailed ocular evaluations were recorded. OCT was performed preoperatively and at postoperative day 1, week 1, and week 4 to assess CMT, SFCT, and microstructural changes, including cystic spaces, retinal pigment epithelium (RPE) alterations, and foveal contour.ResultsMean age was comparable between groups (p = 0.59). Diabetic eyes showed significantly higher FBS, PPBS, and HbA1c values (p < 0.001). Visual improvement occurred in all eyes, but non-diabetic eyes recovered faster (day 1: 0.45 vs. 0.54 logarithm of the minimum angle of resolution (LogMAR), p = 0.002; week 1: 0.28 vs. 0.38, p < 0.001), with comparable vision by week 4 (p = 0.078). Diabetic eyes demonstrated a greater rise in mean CMT (265.6 → 274.0 µm) than non-diabetic eyes (255.0 → 269.0 µm; p < 0.05). SFCT showed opposite trends-non-diabetic eyes thickened (265 → 275 µm), whereas diabetic eyes thinned (229 → 223 µm; p < 0.001). At week 4, 15 of 65 diabetic eyes (23.1%) exhibited cystic spaces and RPE alterations. PHACO provided faster visual recovery but was associated with greater CMT rise and SFCT thinning, whereas SICS showed relatively better postoperative structural stability.ConclusionCataract surgery improved visual acuity in all eyes; however, diabetic eyes exhibited higher postoperative CMT and reduced SFCT, suggesting increased microvascular fragility. Integration of OCT-based parameters with HbA1c enhances postoperative risk assessment. PHACO offers faster recovery in non-diabetic eyes, while SICS may ensure better retinal-choroidal stability in diabetic eyes.

To evaluate the efficacy of second-stage phacoemulsification (PE) of complicated initial cataract after vitreoretinal surgery (VRS) in patients with advanced proliferative diabetic retinopathy (PDR). Totally 216 patients with PDR and complicated initial cataract who underwent surgery were included. These patients were divided into four groups according to their management. In the 1st group patients were subjected to a two-step surgical procedure: VRS with silicone oil tamponade was performed as the first step, followed by the second step, PE+intraocular lens (IOL) implantation+silicone oil removal. In the 2nd group PE was performed simultaneously with VRS and silicone oil tamponade. The second step differed in the removal of silicone oil from the vitreous cavity. Patients Ia (n=17) and IIa (n=17) subgroups had their tear liquid samples being examined before surgery and on the 2nd day after the 1st phase. In subgroups Ib and IIb, an angiogenesis inhibitor was implanted 10-14d before VRS at a dose of 0.5 mg once. In the 3rd group patients were subjected to a two-step surgical procedure: VRS with gas tamponade performed as the 1st step in their treatment; followed by the 2nd step, PE and the IOL implantation. In the 4th group PE performed simultaneously with VRS with gas tamponade. Patients in subgroup Ia and group III had better functional results than those in subgroup IIa and group IV, respectively (P<0.001). More marked inflammatory response (2-3 points) was statistically significant in patients of the IIa subgroup (P<0.001) and group IV (P<0.001) in comparison with the patients in the Ia and group III respectively. The IIa subgroup (n=9; 14.5%) showed higher incidence of neovascular glaucoma (NVG) than the Ia (n=2; 3.2%), P=0.027. There also was a higher rate of NVG in group IV (n=6; 19.3%) compared to group III (n=1; 3.1%), P=0.04. Subgroup IIa revealed a 2 to 2.5 times higher concentration of interleukin 8 (IL-8), monocyte chemoattractant protein 1 (MCP-1), and inter-cellular adhesion molecule 1 (ICAM-1) compared to subgroup Ia. PE of initial cataract at the second stage after VRS in patients with advanced PDR provides a sparing approach to surgical treatment in this category of patients and allows to improve anatomical and functional results of VRS. In addition, it contributes to reduction of number and severity of postoperative complications.

Purpose. To compare Kane and Barrett toric formulas using different keratometric parameters. Material and methods. The study included 31 patients (31 eyes) who underwent phacoemulsification (PE) with implantation of the Clareon® Toric CNW0T2-T9 TIOL (Alcon, USA). Biometry was performed on IOL-Master 700 (Carl Zeiss, Germany), and keratopography on CASIA OCT SS-1000 device (Tomey, Japan). TIOL was calculated using Kane and Barrett toric calculator (BTC) formulas using various keratometric data. Mean centroid error (MCE) and mean absolute centroid error (MACE), frequency of target cylinder hitting within ±0.25, ±0.50, ±0.75, ±1.00, and over 1.00 D were compared. Results. The lowest MCE (0.19 ± 0.92 D) and MACE (0.82 ± 0.43 D), as well as a higher frequency of target cylinder hitting (90%) were shown by Kane formula when IOL-Master keratometric values were used. BTC was slightly less accurate — MCE (0.27 ± 0.96 D), MACE (0.86 ± 0.48 D), the frequency of target cylinder hitting within ±1.00 D was 84% when anterior corneal surface data by IOL-Master and the posterior corneal values by CASIA topographer were used. Conclusion. Kane formula demonstrates the best refractive results for TIOL calculation using standard IOL-Master keratometry data.

Background: Cataracts and glaucoma are prevalent in the elderly, often co-occurring. Cataract surgery in glaucoma patients reduces intraocular pressure (IOP), improves visual acuity (VA), and enhances glaucoma monitoring. Two main surgical techniques exist, phacoemulsification (PE) and manual small-incision cataract surgery (MSICS). Objective: To compare the outcomes of MSICS and PE in Primary open angle glaucoma (POAG) patients with hard cataracts, focusing on postoperative corneal edema, IOP, and corneal endothelial cell density (CECD). Materials and Methods: The present study was a retrospective cohort study that analyzed 80 eyes from 71 POAG patients with hard cataracts, of LOCS III N3, C3, or higher, who underwent either MSICS or PE at Prapokklao Hospital between November 2020 and December 2022. Exclusion criteria included IOP greater than 25 mmHg despite medical treatment, acute angle closure glaucoma, glaucoma secondary to trauma, and other comorbidities. Central corneal thickness (CCT) and CECD were measured pre- and post-operatively at day-1, day-7, month-1, -3, -6, -12, and -18. IOP and glaucoma medication were also tracked. Results: One day postoperatively, CCT increased significantly more in the PE group, at 53 μm, than in the MSICS group, at 40 μm (p=0.022). However, both groups returned to near preoperative CCT levels by one month. Both surgical methods significantly reduced IOP at 1, 3, and 12 months postoperatively, but the reduction was significantly greater in the MSICS group at 1 month (p&lt;0.001). VA significantly improved in both groups at 3 months postoperatively. CECD decreased in both groups at 18 months, but the difference was not statistically significant (p=0.058). At 6 and 18 months, significantly more patients in the MSICS group used only one glaucoma medication (p=0.009, 0.015). Conclusion: PE resulted in a significantly greater increase in CCT one day postoperatively compared to MSICS. Long-term changes in CECD were not significantly different between the groups. Both surgical methods resulted in significant IOP reduction at 1 month postoperatively, with MSICS showing a greater reduction.

PurposeTo assess the surgical outcomes of visco-circumferential-suture-trabeculotomy-synechiolysis (VCSTS) with phacoemulsification compared with phacoemulsification alone for the treatment of chronic primary angle closure glaucoma (PACG).SettingsMansoura Ophthalmic Center, Mansoura, Egypt.DesignRetrospective double armed interventional non randomized comparative study.MethodsA total of 88 eyes (69 patients) with uncontrolled PACG between 2016 and 2022 were subjected to VCSTS with phacoemulsification (Group 1) or phacoemulsification (PE) alone (Group 2). The follow-up period was 24 months. Success was defined as an IOP between 6 and 18 mmHg, with a reduction of at least 30% from baseline with (qualified) or without (complete) antiglaucoma medications (AGMs).ResultsThe mean ± standard deviation ages of the study patients in groups 1 and 2 were 61.1±0.9 and 61.7±0.8 years (p=0.536), respectively. The means ± standard deviations of the preoperative and final postoperative IOP and AGM in groups 1 and 2 were 27.46±0.32 and 28.0±0.3 and 14.15±1.1 and 16.7±0.71 mmHg, respectively (p<0.001), and 3.18±0.07 and 3.2±0.9 and 0.47±1.1 and 1.1±1.5, respectively (p=0.035). The rates of complete success (Kaplan‒Meier) in groups 1 and 2 were 95.3% and 86.7%, respectively (p=0.153). Mild self-limited hyphema was the most common complication in Group 1, with no serious complications reported in Group 2.ConclusionsPhacoemulsification results in a significant and sustained reduction in IOP and the need for AGMs for at least 2 years of follow-up. The addition of VCSTS to phacoemulsification provides a greater reduction in IOP and AGMs and improved surgical success without serious complications.

Purpose. Primary angle-closure glaucoma (PACG) is a leading cause of irreversible blindness globally, with elevated intraocular pressure (IOP) as a critical risk factor. Surgical interventions, such as phacoemulsification (PE) with intraocular lens (IOL) implantation and peripheral iridectomy (PI), have shown efficacy in IOP control and visual restoration. This study evaluates the long-term clinical outcomes of PE and IOL combined with PI in PACG management. Material and Method. A retrospective case series was conducted involving 13 PACG patients (22 eyes) who underwent PE and IOL or PE and IOL with PI between 2018 and 2023. Data were collected from medical records, including pre- and postoperative IOP and best corrected visual acuity (BCVA). Follow-up assessments were performed on Day 1, Month 1, Month 3, Month 6, and annually up to Year 4. Result. Both surgical approaches effectively reduced intraocular pressure (IOP) and improved best corrected visual acuity (BCVA). The addition of PI showed a more consistent early postoperative IOP reduction (100% of eyes decreased from baseline to day 1 and month 6) and maintained lower IOP in the majority of cases over long-term follow-up. BCVA improved in all eyes except those with baseline no light perception (LP-), with the PE + PI group demonstrating greater and more sustained visual improvement. However, some cases in the PE-only group experienced IOP elevation or vision decline during follow-up. Conclusions. PE and IOL, particularly when combined with PI, provides superiority in early IOP control and sustained BCVA gain. However, irreversible optic nerve damage at baseline remains a limiting factor for visual recovery.

Glaucoma and cataract often occur together. According to various studies, the combination of these two conditions is diagnosed in 14–76% of cases. Combined surgical intervention in patients with refractory glaucoma and cataract enables sustained intraocular pressure (IOP) control and significant improvement in visual function. This article presents clinical experience with endoscopic laser cyclodestruction (ELCD) combined with phacoemulsification (PE) in patients with uncontrolled open-angle glaucoma (OAG). The study analyzed data from 110 patients (mean age: 73.78 years) with follow-up ranging from 6 to 60 months. The primary objectives were to assess the combined method’s efficacy in reducing IOP, decreasing the number of antiglaucoma medications, and stabilizing glaucomatous progression. The results demonstrated a significant IOP reduction of 24.6% (5.5 ± 3.8 mmHg; p &lt; 0.001), with the greatest efficacy observed in patients with baseline IOP of 27–32 mmHg. The mean number of antiglaucoma medications decreased from 2.5 ± 1 to 1.9 ± 1 (p = 0.001). Computerized perimetry confirmed glaucoma stabilization without progression. ELCD proved highly effective regardless of the laser treatment extent (180–360°), suggesting that 180–200° of ciliary body ablation is sufficient. The technique is safe, with no significant contraindications (except for technical challenges during PE), and can be considered a key component of minimally invasive glaucoma surgery. Keywords: endoscopic laser cyclodestruction; glaucoma; phacoemulsification; intraocular pressure; antiglaucoma medications

Purpose. Review surgical treatment clinical case of rhegmatogenous retinal detachment (RRD) from the standpoint of the effectiveness of single-stage combined phacovitrectomy (FVE), as a combination of microinvasive vitrectomy and cataract phacoemulsification (PEC). Patient and methods. A clinical case of a patient diagnosed with RRD, proliferative vitreoretinopathy (PVR) stage “C” posterior 1, moderate myopia, peripheral vitreochorioretinopathy is presented. Surgical intervention was performed using the ophthalmological surgical system “Alcon Constellation Vision System” (USA) and the microscope “Leica Proveo 8” (Switzerland). The ophthalmologic status was assessed using standard methods based on ultrasound examination (Quantel medical compact touch, France), photo recording of the fundus and optical coherence tomography of the macular region (on the Topcon 3D OCT-1 Maestro tomograph, Japan).Results and conclusion. Surgical treatment was performed in the volume of combined FVE 25 Ga with implantation of an intraocular lens and tamponade of the vitreous chamber with “light” silicone oil with a viscosity of 2000 cSt. The results of surgical treatment indicate high efficiency and safety of the FVE technique, which is confirmed by the absence of recurrence of the disease and the need for additional surgical interventions during dynamic observation for up to 6 months. The presented clinical case demonstrates a number of significant advantages of the FVE method, which include, in particular, safe and controlled implementation of PEC, due to the support of the capsular bag by the preserved vitreous body, optimal visualization of the fundus structures and vitreous body peripheral parts, the absence of an additional stage of surgical intervention to remove cataracts associated with rehospitalization and psychoemotional stress directly affecting the patient’s quality of life.