Phaco-MIGS combines phacoemulsification cataract surgery with a micro-invasive glaucoma surgery (MIGS) device in a single 20–35 minute day-case operation. As your surgeon removes the clouded lens, a tiny stent — such as the iStent inject W or Hydrus Microstent — is placed in the eye's natural drainage channel to lower intraocular pressure and reduce reliance on glaucoma drops. At our partner clinics, combined phaco-MIGS starts from £4,950 per eye, all-inclusive of the cataract surgery, intraocular lens, MIGS device and aftercare.
What is phaco-MIGS?
Many people develop a cataract and open-angle glaucoma at the same stage of life. Rather than treating each separately, phaco-MIGS tackles both in one procedure. Phaco refers to phacoemulsification — standard cataract surgery, where the cloudy natural lens is removed and replaced with a clear intraocular lens. MIGS — micro-invasive glaucoma surgery — adds a microscopic stent or channel that improves the eye's natural fluid drainage, lowering pressure on the optic nerve.
Because the cataract incision is already made, the MIGS device is implanted through the same opening, adding only a few minutes to the operation. The result is one anaesthetic, one recovery and two conditions managed together — which is why combined surgery has become the standard of care for patients with coexisting cataract and mild-to-moderate glaucoma.
Who is suitable?
- You have a visually significant cataract causing glare, blur or faded colours
- You also have open-angle glaucoma or raised eye pressure (ocular hypertension)
- Your glaucoma is mild to moderate and currently controlled on drops
- You would like to reduce your drop burden — many patients stop one or more medications
- You want a single operation rather than two separate procedures
Have both a cataract and glaucoma? A combined assessment confirms whether phaco-MIGS is right for you and which stent best suits your eye.
Book a combined assessmentMIGS stent options
Several MIGS devices can be combined with cataract surgery. Your consultant selects the most appropriate one based on your eye's drainage anatomy, your target pressure and how many drops you are currently using.
Prefer to read about the devices individually? See our pages on the iStent MIGS procedure, the Hydrus Microstent and OMNI canaloplasty.
What happens during combined surgery
The procedure is performed under local anaesthetic eye drops. You stay awake but feel no pain — only mild pressure and light. It takes 20 to 35 minutes per eye, and you'll be at the clinic for around 2 to 3 hours including pre-op checks and post-op rest.
- Numbing drops are placed in your eye and the surrounding skin is cleaned with sterile solution.
- The surgeon makes a tiny 2.2–2.8mm self-sealing incision at the edge of the cornea.
- The cataract is removed by phacoemulsification and your chosen intraocular lens is implanted into the capsular bag.
- Through the same incision, the MIGS stent is placed into the eye's natural drainage channel (Schlemm's canal) under a special microscope lens.
- The eye is shielded and you rest for 30–60 minutes before going home.
Recovery week-by-week
Recovery closely mirrors standard cataract surgery. Most patients see clearly within days, with eye-pressure benefits settling over the following weeks.
Day of surgery
Vision is hazy for a few hours. Eye shield worn the first night. No driving or heavy lifting. Drops begin.
Days 1–3
Vision clears noticeably. Mild grittiness or watering is normal. Gentle activities and reading resume.
Week 1
First review checks vision and eye pressure. Most patients are back to driving and work — no swimming or eye rubbing yet.
Weeks 2–4
Vision refines and pressure stabilises. Your surgeon reviews which glaucoma drops can be reduced or stopped.
Beyond a month
Final vision settles. Ongoing pressure monitoring continues with your glaucoma team to protect long-term sight.
Cost & insurance
Our combined phaco-MIGS prices are all-inclusive: consultation, biometry, the cataract surgery, your intraocular lens, the MIGS device, theatre and hospital fees, post-op drops and follow-up reviews.
- Self-pay: from £4,950 per eye with iStent inject W; from £5,400 with Hydrus Microstent; from £5,200 with OMNI canaloplasty. Premium lenses are an optional upgrade.
- Insurance: recognised by Bupa, AXA, Aviva, Vitality, Cigna, WPA and others. We handle authorisation.
- Finance: 0% options available — spread the cost over 12 months.
For standalone glaucoma procedure pricing, see private glaucoma surgery costs or the iStent infinite option for patients without a cataract.