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Delicate balance of the IOP control and choroidal effusion is of utmost concern for outcomes in patients with angle closure glaucoma secondary to nanophthalmos. Here, we presented a surgery of phacoemulsification, combined with irido-zonulo-hyaloid-vitrectomy, Ahmed glaucoma valve implantation and full-thickness drainage sclerotomy in a 32 years old patients with ACG secondary to nanophthalmos.