Mode
Text Size
Log in / Sign up

Combined phacoemulsification and angle filtering reduce intraocular pressure and medication needs in glaucoma patientsCombined surgery lowers eye pressure better than cataract surgery alone

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider combined phacoemulsification and angle filtering to reduce intraocular pressure and anti-glaucoma medication needs.

This meta-analysis of 14 randomized controlled trials evaluated the efficacy of combined phacoemulsification and angle filtering procedures compared to phacoemulsification alone in patients with primary glaucoma and coexisting cataracts. The analysis focused on intraocular pressure (IOP), medication requirements, and visual outcomes.

The pooled results indicate that combined procedures are significantly more effective at reducing IOP (MD -1.98; CI: -2.71 to -1.25, p < 0.0001). Additionally, patients undergoing combined procedures required fewer anti-glaucoma medications (MD -0.69; CI: -0.87 to -0.52, p < 0.0001). Regarding best-corrected visual acuity (BCVA), the difference was small (MD 0.07; CI: 0.01 to 0.13, p = 0.03) compared to phacoemulsification alone without MMC.

Safety data indicates a higher rate of complications for combined procedures. While the meta-analysis suggests clinical superiority in pressure reduction and medication reduction, these findings are based on pooled RCT data. Clinical application should consider the trade-off between improved IOP control and the reported increase in complication rates.

If you have both glaucoma and cataracts, you might face a tough choice: treat one condition now and the other later, or do both at once. A new analysis of 14 clinical trials suggests that combining cataract surgery with a procedure to lower eye pressure may be the smarter move.

The meta-analysis looked at patients with primary glaucoma and cataracts. Those who had combined phacoemulsification (cataract removal) plus an angle filtering procedure saw their eye pressure drop nearly 2 mmHg more than those who had cataract surgery alone. They also needed fewer glaucoma medications afterward.

There's a trade-off: the combined surgery came with a higher rate of complications. And while it improved vision, the gain was slightly less than with cataract surgery alone in one subgroup. Still, for many patients, the better pressure control could mean less reliance on drops and a lower risk of glaucoma progression.

This isn't a one-size-fits-all answer. The analysis pooled data from multiple studies, and individual results may vary. Talk to your eye doctor about whether the combined approach is right for you.

What this means for you:
Combined cataract and glaucoma surgery lowers eye pressure more than cataract surgery alone.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
BackgroundTo evaluate the clinical outcomes of combined phacoemulsification and angle filtering procedures versus phacoemulsification alone in patients with primary glaucoma coexisting with cataracts.MethodsRandomized controlled trials comparing combined phacoemulsification and angle filtering procedures with phacoemulsification published before September 24, 2025, were identified through PubMed/Medline, Embase, and Cochrane Library. Intraocular pressure (IOP), anti-glaucoma medications (AGMs), best-corrected visual acuity (BCVA), perimetry, and complications were analyzed in this meta-analysis. Subgroup analyses were conducted based on follow-up duration, angle status, use of mitomycin C (MMC), and surgical approach.ResultsFourteen randomized controlled trials were pooled for analysis. Combined phacoemulsification and angle filtering procedures had a smaller effect on BCVA than phacoemulsification alone without MMC [mean difference (MD) = 0.07, confidence interval (CI): 0.01 to 0.13, I2 = 49%, p = 0.03]. Combined phacoemulsification and angle filtering procedures were significantly more effective in reducing IOP (MD = −1.98, CI: −2.71 to −1.25, I2 = 90%, p < 0.0001) and need of AGMs (MD = −0.69, CI: −0.87 to −0.52, I2 = 73%, p < 0.0001) but associated with a significantly higher rate of complications [risk ratio (RR) = 2.66, CI: 1.82 to 3.89, I2 = 13%, p < 0.00001].ConclusionsCombined phacoemulsification and angle filtering procedures are superior in reducing IOP and need for AGMs. In the subgroup without MMC use, combined angle filtering procedures were associated with a statistically significant difference in BCVA compared with phacoemulsification alone.Systematic review registrationhttps://inplasy.com/inplasy-2026-5-0081/, identifier INPLASY202650081.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.