Purpose  To describe sequential phacoemulsification–IOL implantation–posterior capsulorrhexis–anterior vitrectomy approaches in the management of phakic malignant glaucoma.

Methods  Twenty consecutive patients (25 eyes) with phakic malignant glaucoma were enrolled fromZhongshanOphthalmicCenter,SunYat-senUniversity. All patients underwent phacoemulsification, IOL implantation, and posterior curvilinear capsulorrhexis together with anterior vitrectomy via clear corneal paracentesis. Visual acuity, intraocular pressure (IOP), anterior chamber depth, complications, and medications required after the surgery were determined.

Results  After the sequential approaches, mean LogMAR visual acuity and anterior chamber depth (ACD) increased significantly (visual acuity -0.54±0.81 vs. -1.56±1.17, P < 0.001; ACD 2.390±0.575 mm vs. 0.367±0.397 mm, P < 0.001), and mean intraocular pressure decreased significantly (14.5±4.1 mm Hg vs. 39.6±10.6 mm Hg, P < 0.001)). No serious perioperative complications occurred and only 5 eyes required topical glaucomatous medications after surgery.

Conclusions Combined phacoemulsification–IOL implantation–posterior capsulorrhexis–anterior vitrectomy surgery is a safe and effective treatment for patients with phakic malignant glaucoma.