Combining cataract surgery with PAUL Glaucoma Implant implantation

Glaucoma patients often present with coexisting visually significant cataracts, prompting consideration of combined phacoemulsification and glaucoma drainage device (GDD) implantation. This chapter examines the rationale, surgical considerations, and clinical outcomes of combining cataract surgery with PGI implantation. The current evidence shows that the outcomes of combined PGI and cataract surgery are comparable to standalone PGI surgery. Furthermore, combined surgery confers the additional benefit of visual rehabilitation and prevents the need for a future cataract extraction, which may compromise tube function. Complication rates, including transient hypotony and hyphaema, are low and comparable between combined and standalone approaches. Collectively, the literature affirms that combined cataract extraction with PGI implantation is a safe and clinically effective option for appropriate patients, particularly those with moderate to advanced cataracts and uncontrolled glaucoma.