The landscape of treating glaucoma during cataract surgery is rapidly evolving. Looking to the future, one trend is making glaucoma treatments even less invasive and more integrable with cataract procedures. For example, laser-based MIGS (sometimes dubbed “deviceless MIGS”) are under development: systems like the ELIOS excimer laser trabeculotomy or ViaLase femtosecond laser can create openings in the eye’s drain without any incisions or implants. This could mean that in a few years, a cataract surgeon might simply program a laser to painlessly enhance fluid outflow at the end of cataract surgery – no stent needed, no added wounds. Early studies show these laser techniques can lower pressure with minimal tissue trauma. Another innovation on the horizon is the next generation of MIGS devices and stents: for instance, the PreserFlo MicroShunt (already in use in Europe) or new gel stents that create drainage pathways with even smaller risk profiles. We’re also seeing a merging of technologies: imagine a smart intraocular lens that not only focuses vision but also slowly releases a glaucoma medication or monitors eye pressure internally. Researchers are indeed exploring pressure-sensing implants that could be inserted at cataract surgery, giving doctors continuous eye pressure readings on a smartphone app. In terms of drug delivery, we’ve just discussed the iDose – in the near future, perhaps during your cataract surgery the surgeon could also inject a deposit of medication that keeps pressure low for a year (some doctors already inject a steroid or anti-glaucoma drug at the time of cataract surgery to preemptively strike against pressure rise or inflammation). The horizon also includes the concept of combination therapy: if one MIGS lowers pressure moderately, combining two different MIGS in one eye (for example, a stent + a laser procedure) might achieve additive benefits for more advanced cases, all while still keeping risk low. Clinical trials are ongoing to determine the best combos. Additionally, patient-specific planning aided by AI is up and coming – algorithms might help surgeons predict which glaucoma+cataract patients will benefit most from which procedure(s) based on big data of outcomes. This means a more tailored approach, upping success rates.