Background Various surgical techniques have been described, to be combined with cataract surgery in glaucoma patients, aiming for an additional reduction of intraocular pressure (IOP), hence minimizing the burden of anti-glaucoma medication (AGM). Ultrasound ciliary plasty (UCP) is a recent microinvasive glaucoma surgery (MIGS) recommended for primary and refractory glaucoma. This study was conducted to evaluate the safety and efficacy of a new technique; combined phacoemulsification and ultrasound ciliary plasty (Phaco-UCP) as a primary surgical treatment for coexisting cataract and open angle glaucoma. Methods A randomized clinical trial, including 61 eyes of 61 patients with visually significant cataract and open angle glaucoma, randomized to either Phaco-UCP (study group; 31 eyes) or phacoemulsification alone (Phaco-alone) (control group; 30 eyes). Primary outcomes included reduction in IOP and/or the number of AGM. Secondary outcomes included visual acuity improvement and complications. Qualified Success was defined as an IOP reduction ≥ 20% from baseline value, with an IOP 6–21 mmHg, with no additional AGM or glaucoma surgery. Failure was defined as either < 20% IOP reduction, despite AGM use, the need of glaucoma surgeries or serious complications. Results At 18 months postoperatively, Phaco-UCP group had a median IOP reduction of 7 mmHg (Q1, Q3 = 3, 10) compared to 2 mmHg (Q1, Q3 = 2, 3) in Phaco-alone group (P < 0.001). Phaco-UCP group had significantly higher success rate at all time points reaching 67.7% at the last follow-up versus 16.7% only in Phaco-alone group (P< 0.001). The median number of AGM significantly decreased from [3 (Q1, Q3 = 2, 4), 3 (Q1, Q3 = 2,3)] respectively, (P =0.3)] at baseline to [1 (Q1,Q3 = 1, 2), 2 (Q1,Q3 = 2, 2)] respectively, (P < 0.001)] at 18 months postoperatively. No serious intraoperative or postoperative complications were encountered in either group. Conclusion Phaco-UCP is a simple, safe and effective procedure for management of coexisting cataract and open angle glaucoma. Trial registration ClinicalTrials.gov identifier, NCT04430647; retrospectively registered. June 12, 2020.

Objective: To assess the frequency of intraopertive difficulties, postoperative complications and the visual outcome in cataract surgery performed at the Al-Bahar Eye Center, Kuwait. Subjects and Methods: This case series study is comprised of 350 eyes from 325 subjects (169 male, 156 female; 30–78 years, mean age 64 years) undergoing consecutive cataract surgery performed at the Al-Bahar Eye Center, Kuwait from July 2001 to June 2002. All the eyes underwent extensive ophthalmic examinations before and after surgery. Details of surgical procedures, including the type of the cataract surgery, intraoperative difficulties or complications, postoperative complications, and the visual outcome were documented. Results: The extracapsular cataract extraction (ECCE) technique was used for 50.2% of the eyes and for the remaining 49.8%, the small-incision phacoemulsification technique was used. Of the 350 eyes operated upon, 9.7% had coexisting ocular disease which may have affected the best spectacle corrected visual acuity (BSCVA). Complications included posterior capsule tears and vitreous loss (10%), cystoid macular edema (0.6%) and endophthalmitis (0.9%) of the eyes. A BSCVA of 6/12 or better was achieved in 78.3% of the cases. Conclusion: A high success rate in terms of visual acuity outcome was achieved in the cataract surgery. The operative and postoperative complications were similar for both techniques, ECCE and phacoemulsification.