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Cataract extraction (CE) in the presence of choroidal effusion following trabeculectomy is challenging. If the effusion is drained first, deepening of the anterior chamber can make CE difficult. Conversely, CE before drainage can be difficult due to shallowing from mass effect. In this video, a scleral window is created for limited drainage; after closure of the window, complex CE is performed. The window is reopened during irrigation/aspiration and again after CE.