Objective:

To evaluate the clinical outcomes, specifically intraocular pressure (IOP), anti-glaucoma medications (AGMs), and best-corrected visual acuity (BCVA), of combined phacoemulsification and angle filtering procedures versus phacoemulsification alone in patients with primary glaucoma coexisting with cataracts.

Key Findings:

• Combined phacoemulsification and angle filtering procedures had a smaller effect on BCVA than phacoemulsification alone without MMC (MD = 0.07, CI: 0.01 to 0.13, p = 0.03), indicating limited visual improvement.
• Combined procedures significantly reduced IOP (MD = -1.98, CI: -2.71 to -1.25, p < 0.0001) and the need for AGMs (MD = -0.69, CI: -0.87 to -0.52, p < 0.0001), demonstrating their effectiveness.
• Higher complication rates were associated with combined procedures (RR = 2.66, CI: 1.82 to 3.89, p < 0.00001), highlighting a critical consideration for clinical practice.

Interpretation:

Combined phacoemulsification and angle filtering procedures are more effective in reducing IOP and the need for AGMs, but they are associated with a higher rate of complications, which must be weighed in treatment decisions.

Limitations:

• Only 14 studies were included in the meta-analysis, which may limit the generalizability of the findings and the robustness of conclusions drawn.
• Subgroup analyses based on disease stage and control status were not performed due to insufficient data, potentially overlooking important variations.

Conclusion:

Combined phacoemulsification and angle filtering procedures are superior in reducing IOP and the need for AGMs, but the significant difference in BCVA noted in the subgroup without MMC use must be balanced against the higher complication rates.