Efficacy and safety of combined cataract and glaucoma surgery in patients with lens subluxation and pseudoexfoliation syndrome

Objective: To evaluate the efficacy and safety of a combined surgical approach in patients with primary open-angle glaucoma and cataract complicated by grade I–II lens subluxation in the setting of pseudoexfoliation syndrome. Materials and methods: The study included 40 patients (40 eyes) with POAG stages II–III, cataract, and grade I–II lens subluxation associated with PEX. All patients underwent simultaneous combined surgery: phacoemulsification with IOL implantation using the optic capture technique and non-penetrating deep sclerectomy with implantation of a Healaflow collagen drain. Results: At 12 months after surgery, a significant improvement in uncorrected visual acuity (UCVA) was observed: from 0.12±0.04 to 0.38±0.06 in stage II glaucoma and from 0.04±0.02 to 0.40±0.08 in stage III glaucoma (p<0.001). Intraocular pressure (IOP) decreased to 16.4±2.1 mmHg and 17.0±1.9 mmHg, respectively (p<0.001). Antihypertensive therapy was discontinued in 85% of patients with stage II and 80% with stage III glaucoma. Conclusion: Combined surgical treatment demonstrated high efficacy and safety in patients with this complex ocular pathology.