The video shows the surgical management of a patient with glaucoma undergoing combined deep sclerectomy and cataract surgery with high preexisting astigmatism. The patient was a 62 years old female with uncontrolled glaucoma. Refractive cylinder improved from 3.98 diopters preoperatively to 0.50 diopters. postoperatively. Intraocular pressure dropped from 28 to 12 mmHg without any medications. Final non-corrected visual acuity was 20/20.