When performing cataract surgery in an eye with a prior trabeculectomy there are some important differences. There is going to be additional fluidic outflow through the trab site and than can lead to some anterior chamber instability during phaco. In addition, we want to make a slightly smaller capsulorhexis so that the IOL will be securely held within the capsular bag even if there is over-filtration and flattening of the anterior chamber in the post-op period. We must also remove any viscoelastic to prevent it from blocking fluid outflow via the trab site. This video provides some important pearls for success.
