In phacomorphic glaucoma with limited view, how do you approach surgical management (i.e., staged or combined surgery, temporize with LPI)?

In true phacomorphic glaucoma, the definitive treatment is cataract extraction. I first focus on medically lowering the IOP, and if the cornea is hazy, I do everything possible to clear it to obtain a safe surgical view. If the view remains limited, I’m comfortable using the biometry from the fellow eye to guide IOL selection. I generally do not rely on an LPI, since the lens is mechanically obstructing the angle. Instead, temporizing with aggressive IOP control is more appropriate until cataract surgery can be performed.