Combining cataract and glaucoma surgery in a single procedure is not new. Alan N. Carlson, M.D., Professor of Ophthalmology and Chief of the Corneal and Refractive Surgery Service at the Duke Eye Center in Durham, NC has the enormous privilege of working along with one of the top Glaucoma Services in managing patients that have co-existing Glaucoma along with cataracts and corneal problems. A “best practices” approach to patients that simultaneously have visually significant cataracts along with poorly controlled glaucoma is to combine cataract surgery with trabeculectomy. Drs. James Kim and Rand Allingham of the Glaucoma Service at the Duke Eye Center demonstrate meticulous surgical attention to this patient who has both visually significant cataracts and poorly controlled glaucoma. “The Duke Difference” means taking each patient individually and designing a program and procedure that is optimal and specific to their needs.