When You Have Cataracts and Glaucoma

Cataracts and glaucoma can occur together naturally, one condition can influence the other, or cataracts may even develop following certain glaucoma surgeries.

When glaucoma surgery is needed, it can often be an ideal time to remove a cataract as well—without significantly increasing surgical risk. Likewise, when a glaucoma patient needs cataract surgery, the procedure can sometimes be combined with a glaucoma surgery. This approach may reduce the need for glaucoma eye drops or help improve eye pressure control, usually without adding significant risk.

Cataract surgery can be combined with several different glaucoma procedures, including trabeculectomy, glaucoma drainage implants, endocyclophotocoagulation (ECP), microshunts, and various minimally invasive glaucoma surgeries (MIGS). MIGS procedures are often performed at the same time as cataract surgery since they can typically be done through the same small corneal incision. However, because most MIGS techniques rely on the eye’s natural drainage system, they may not always lower eye pressure enough to eliminate the need for glaucoma eye drops entirely.

Your surgeon will discuss the available options and recommend the approach best suited to you, taking into account factors such as the stage of your glaucoma, your overall health, age, lifestyle, and how well you tolerate glaucoma medications.

In some cases, cataract surgery alone may be appropriate. For example, in patients with mild open-angle glaucoma or ocular hypertension, cataract surgery itself can sometimes lower eye pressure enough without additional glaucoma procedures.

Certain types of glaucoma, such as pseudoexfoliation glaucoma, present unique challenges during cataract surgery. This condition can weaken the natural support structures of the lens (the zonules), making surgery more delicate. In addition, some newer intraocular lens (IOL) designs may not be suitable for glaucoma patients, as they can affect contrast sensitivity or cause glare.

It’s also important to note that temporary increases in eye pressure are more common after cataract surgery in patients with glaucoma—and even short-term pressure spikes can pose a risk to the optic nerve.

Surgeons experienced in caring for patients with both cataracts and glaucoma understand these complexities and take special precautions to ensure the best possible outcomes.

In summary:
When cataracts and glaucoma occur together, treatment must be carefully tailored to each patient. There are several surgical options and many factors to consider. A thorough discussion with your eye doctor will help determine the approach that best meets your individual needs and provides the safest, most effective care.

Article by Davinder S. Grover, MD, MPH. Last updated on October 20, 2025