To compare the refractive outcomes in patients following either combined or sequential trabeculectomy and phacoemulsification.

Evaluation of the medical records of patients who underwent one of three treatment combinations on their eyes including combined phaco-trabeculectomy (47 eyes), a sequential phacoemulsification procedure, at least 3 months following trabeculectomy (33 eyes), and phacoemulsification alone (48 eyes).

There were no significant differences among the three groups in characteristics such as age, sex, axial length, the postoperative spherical equivalent (SE) and refractive prediction error (RPE) at 1 week and 2 months post procedure. Significant differences existed between the three groups in terms of preoperative intraocular pressure, predicted SE, and the mean absolute error (MAE) at 1 week and 2 months post procedure. The proportions of cases with a RPE > 1.0 diopter (D) or <−1.0 D were significantly different between the three groups.

There were significant differences between the three groups in terms of the MAE at 1 week and 2 months after surgery. With respect to the predicted SE, phacotrabeculectomy seems to be less accurate than the phacoemulsification alone. Therefore, careful consideration should be given to the selection of the intraocular lens power.