Medically reviewed by Dr. Ruhi Soni, MD
Board-Certified Ophthalmologist • Soni Vision Institute
If you are over the age of 60, there is a real chance you may be dealing with two eye conditions at once: glaucoma and cataracts. Both conditions become more common with age, and it is not unusual for them to develop side by side. The good news is that modern surgical techniques now allow both to be addressed in a single procedure, saving you time, reducing recovery, and potentially improving your quality of life faster than treating each condition separately.
Why Glaucoma and Cataracts Often Occur Together
Cataracts involve the gradual clouding of the eye's natural lens, leading to blurred vision, glare, and difficulty seeing in low light. Glaucoma, on the other hand, is a group of conditions that damage the optic nerve, usually due to elevated pressure inside the eye. Both conditions are strongly associated with aging, which is why so many patients present with both at the same time.
In fact, studies show that a significant percentage of patients who come in for cataract evaluation also have some degree of glaucoma. For these patients, the question often becomes: do I need two separate surgeries, or can everything be handled at once?
What Is MIGS?
MIGS stands for micro-invasive glaucoma surgery. Unlike traditional glaucoma surgeries, which can involve larger incisions and longer recovery periods, MIGS procedures use tiny devices or microscopic openings to improve the eye's natural drainage system. The goal is to lower intraocular pressure with minimal trauma to the eye.
MIGS represents one of the most significant advances in glaucoma care in decades. These procedures are designed to be gentler, faster, and more predictable than older surgical approaches.
There are several categories of MIGS devices, each working through a slightly different mechanism. Some create a new drainage pathway within the eye's natural anatomy. Others bypass the traditional drainage system entirely. Your surgeon will recommend the approach best suited to your specific type and stage of glaucoma.
Combining MIGS with Cataract Surgery
One of the most exciting aspects of MIGS is that many of these procedures can be performed at the same time as cataract surgery. Since both surgeries are performed through a small incision in the cornea and under the same type of anesthesia, combining them is a natural fit.
During a combined procedure, your surgeon first removes the clouded lens and replaces it with an artificial lens implant, just as in standard cataract surgery. Then, using the same microscopic incision, the MIGS device is placed or the drainage pathway is created. The entire procedure typically takes only a few minutes longer than a standard cataract surgery.
Benefits of Combined Surgery
- One recovery period. Instead of healing from two separate procedures weeks or months apart, you recover from both at the same time.
- Reduced dependence on eye drops. Many glaucoma patients rely on daily drops to manage their eye pressure. After a successful MIGS procedure, some patients are able to reduce or even eliminate their drop regimen.
- Lower overall risk. Each time you undergo anesthesia and surgery, there is a small amount of risk. Combining procedures means only one trip to the operating room.
- Improved vision and eye health in one step. You address both the cloudy lens and the elevated pressure in a single visit.
Am I a Candidate?
Not every patient with both glaucoma and cataracts will be a candidate for combined surgery. The decision depends on several factors, including the type and severity of your glaucoma, how well your pressure is controlled with current medications, and the overall health of your eyes.
Patients with mild to moderate open-angle glaucoma who are already planning cataract surgery tend to be the best candidates. If your glaucoma is more advanced, your surgeon may recommend a more traditional glaucoma procedure either before or after cataract surgery.
Why Surgeon Experience Matters
Combining these procedures requires a surgeon who is experienced in both cataract surgery and glaucoma management. Not all cataract surgeons perform MIGS, and not all glaucoma specialists perform high-volume cataract surgery. Finding a practice where both areas of expertise come together is essential.
At Soni Vision Institute, Dr. Ruhi Soni and Dr. Nikitha Reddy are board-certified ophthalmologists who are highly trained in both cataract and glaucoma surgery. This means your evaluation, surgical planning, and follow-up care all happen under one roof, with surgeons who understand how both conditions interact.
What to Expect After Surgery
Recovery from a combined cataract and MIGS procedure is very similar to recovery from cataract surgery alone. Most patients notice improved vision within a few days. Your surgeon will monitor your eye pressure closely in the weeks following surgery to ensure the MIGS component is working as expected.
You may still need some eye drops during the early recovery period, but the long-term goal is to reduce your dependence on glaucoma medications. Your care team will work with you to taper drops as your pressure stabilizes.
Take the Next Step
If you have been diagnosed with both glaucoma and cataracts, or if you suspect you may have both conditions, a comprehensive evaluation is the first step. Our surgeons can assess your eyes, discuss whether combined surgery is right for you, and create a personalized treatment plan.
Schedule a consultation at Soni Vision Institute to learn more about your options.