A monocular patient is always a challenge because the patient has just the one eye. This often instills a fear of surgery in the patient because they wonder about the “what if” possibilities. Certainly every surgery has some degree of risk, no matter how small, and with monocular patients they are placing everything on the line. With modern techniques of surgery and a highly experienced surgeon (the most important factor), we can deliver excellent visual outcomes to these patients while minimizing the risk. We have previously shown cases of cataract surgery in the setting of an active and filtering bleb, however in this case the trab site looks vascularized with a collapsed bleb. Due to prior glaucoma procedures this patient has well controlled glaucoma and now his glaucoma specialist has referred him for cataract surgery. This video is a complete cataract case shown start to finish wherein I give you my best pearls for success in these case.