Clinical Report: Postoperative Complications in Cataract Surgery with MIGS

Overview

This study evaluates postoperative complications in patients with primary open-angle glaucoma undergoing cataract surgery alone versus combined with minimally invasive glaucoma surgery (MIGS). The findings show a higher incidence of hyphema in the combined surgery group, while other complications such as cystoid macular edema, retinal detachment, and endophthalmitis showed no significant differences.

Background

Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness. Cataract extraction with intraocular lens implantation (CE/IOL) is a common procedure that can lower intraocular pressure (IOP). Understanding the risks associated with combined CE/IOL and MIGS is important for surgical outcomes.

Data Highlights

Key Findings

• Patients undergoing CE/IOL with MIGS had a higher rate of hyphema compared to those undergoing CE/IOL alone.
• The cumulative incidence of hyphema was 1.19% for the combined surgery versus 0.15% for CE/IOL alone.
• No statistically significant differences were found in the rates of cystoid macular edema, retinal detachment, or endophthalmitis between the two groups.
• Propensity score matching was utilized to balance baseline characteristics between the cohorts.
• Similar trends were observed in both routine and complex CE/IOL procedures combined with MIGS.

Clinical Implications

Surgeons should be aware of the increased risk of hyphema associated with combined CE/IOL and MIGS procedures.

Conclusion

The study reports a higher rate of postoperative hyphema in patients undergoing combined CE/IOL with MIGS compared to those undergoing CE/IOL alone, while rates of other complications remained comparable.

Related Resources & Content

1. Ophthalmology Management, 2016 -- The in-tandem surgical dilemma
2. Frontiers in Ophthalmology, 2026 -- Combined phacoemulsification and angle filtering procedures versus phacoemulsification with clinical outcomes in primary glaucoma coexisting with cataracts: a meta-analysis of randomized controlled trials
3. Glaucoma Physician, 2022 -- Postoperative Management of MIGS Recommendations
4. PubMed, 2026 -- Primary Open-Angle Glaucoma Preferred Practice Pattern®
5. Frontiers in Medicine — Phacoemulsification with IOL implantation combined with goniosynechialysis and goniotomy in primary angle-closure glaucoma following failed trabeculectomy: short-term effectiveness and safety outcomes
6. Primary Open-Angle Glaucoma Preferred Practice Pattern® - PubMed
7. Combined Microinvasive Glaucoma Surgery With Phacoemulsification in Open-Angle Glaucoma: A Systematic Review and Meta-analysis - PubMed