A patient with hemophilia a undergoing sequential glaucoma and cataract surgery: A case report

Performing intraocular surgeries such as glaucoma and cataract surgery in patients with severe hemophilia poses a significant challenge due to the high risk of vision-threatening hemorrhagic complications. There are few reports on the safe implementation of ophthalmic surgeries in patients with severe coagulation disorders complicated with multiple ocular diseases. A 49-year-old male patient with severe Hemophilia A and a 12-year history of Posner-Schlossman syndrome (PSS) was treated for secondary glaucoma in his right eye with trabeculectomy in October 2023. In October 2025, he received phacoemulsification and intraocular lens implantation for complicated cataracts caused by PSS in the same eye. With perioperative replacement therapy using coagulation factor concentrates and standardized and individualized surgical management measures, both surgeries were successfully completed and no serious postoperative bleeding-related complications occurred in the patient. This case demonstrates the feasibility of safe sequential glaucoma and cataract procedures in patients with severe coagulation disorders like hemophilia, when supported by perioperative coagulation factor replacement and individualized surgical protocols. In future ophthalmic surgeries, it is necessary to take into account both the recommended dosage in the guidelines and the patient’s psychological expectations, while also incorporating individualized pharmacokinetic testing, to ensure the safe and successful performance of the surgery.