ORIGINAL RESEARCH article
Front. Ophthalmol.
Sec. Glaucoma
This article is part of the Research TopicEmerging Strategies in Glaucoma Treatment: MIGS, Cataract Surgery, and Novel Tube Placement InnovationsView all articles
A Novel Retrobulbar/Intraconal Surgical Approach with Combined Cataract Extraction and a Modified AHMED ClearPath 250mm2 tube in the Ciliary Sulcus with an Inferior Sclerotomy in Black and Afro-Latino Patients with Advanced Glaucoma: a 6-month Retrospective Study
Provisionally accepted
- 1New York University, New York, United States
- 2Advanced Eyecare of New York, New York, United States
- 3City College of New York (CUNY), New York City, United States
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Aim: The purpose of this early safety and technical feasibility study was to evaluate the real-world performance of cataract extraction combined with a modified Ahmed ClearPath 250 mm² glaucoma drainage device placed in the retrobulbar/intraconal space with inferior sclerotomy in glaucoma patients, focusing on surgical tolerability, device stability, and preliminary safety outcomes while acknowledging limitations in sample size and follow-up that preclude definitive efficacy claims. Methods: This study was conducted at Advanced Eye Care of New York, a private practice located in NY, NY. This was a single-center, retrospective study of 12 patients who underwent combined phacoemulsification cataract surgery and glaucoma surgery using a retrobulbar/intraconal AHMED® ClearPath 250mm2 and an inferior sclerotomy technique. We report results at 6 months of follow-up. Investigated parameters were intraocular pressure, number of medications, mean deviation on visual field test, visual acuity, and adverse events. Results: Among all the 12 eyes undergoing combined cataract extraction and retrobulbar/intraconal AHMED® ClearPath 250mm² placement with inferior sclerotomy, mean IOP decreased from 18.08 to 14.83 mmHg (18.0% reduction) at 6 months. Topical medications decreased from 2.67 to 1.0 (62.5% reduction). Visual field MD remained stable (-18.59 dB to - 18.15 dB). Five patients achieved trabeculectomy-like results (IOP ≤12 mmHg on ≤1 medication). Complications were limited to temporary post-op hypotony and shallow anterior chamber, with no bleb, diplopia, or additional astigmatism. Conclusion: Cataract extraction combined with a modified Ahmed ClearPath 250 mm² glaucoma drainage device placed in the retrobulbar/intraconal space via inferior sclerotomy shows preliminary promise in reducing intraocular pressure and medication burden in Black and Afro-Latino patients with advanced glaucoma. These exploratory findings from a small cohort suggest technical feasibility and short-term safety, warranting further research with larger samples and longer follow-up to confirm efficacy and generalizability.
Keywords: Advanced glaucoma, Ahmed ClearPath glaucoma drainage device, Combined cataract-glaucoma surgery, Inferior Sclerotomy, Retrobulbar/intraconal placement
Received: 03 Nov 2025; Accepted: 11 Feb 2026.
Copyright: © 2026 Laroche, Calderon and Nwokeji. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Daniel Laroche
Imani Nwokeji
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