The surgical management of a patient presenting with iris bombé, acute angle-closure glaucoma and cataract poses a complex challenge that requires careful planning and skilled intraoperative execution.
Iris bombé results from 360° posterior synechiae that cause the iris to bow forward, creating a pupillary block that leads to elevated IOP and closure of the anterior chamber angle (Figure 1). When this condition is compounded by a mature or swollen cataract, the anterior segment becomes shallow and pressurized, significantly increasing the risk for optic nerve damage and vision loss. While