Objective: To comparatively analyze the clinical efficacy and safety of phacoemulsification with intraocular lens implantation (Phaco-IOL) combined with intracameral injection of anti-vascular endothelial growth factor (anti-VEGF) drugs and dexamethasone sustained-release implants (DEX) versus Phaco-IOL alone for the treatment of neovascular glaucoma (NVG) complicated with cataract.Methods: A total of 80 patients (80 eyes) with neovascular glaucoma (NVG) complicated by cataract, who were admitted to the Ophthalmology Department of the Seventh Affiliated Hospital of Xinjiang Medical University in conjunction with the Ophthalmology Department of Xinjiang Production and Construction Corps Hospital from March 2022 to March 2025, were selected. These patients were randomly divided into a combined treatment group (40 eyes) and a control group (40 eyes) using the random number table method. The combined treatment group underwent Phaco-IOL + intracameral injection of anti-VEGF drugs + DEX implantation, while the control group underwent Phaco-IOL alone. Best-corrected visual acuity (BCVA, LogMAR), intraocular pressure (IOP), anterior chamber inflammation (aqueous flare), regression of iris neovascularization (NVI), the number of antiglaucoma medications used, and complications were observed before surgery and at 1 day, 1 week, 1 month, 3 months, and 6 months after surgery.Results: At 6 months postoperatively, the mean BCVA (LogMAR) in the combined treatment group was significantly better than that in the control group (P < 0.01), and the mean IOP (mmHg) was significantly lower (P < 0.01). The mean number of antiglaucoma medications used was significantly lower in the combined treatment group (P < 0.01). The complete regression rate of NVI at 1 week postoperatively was significantly higher in the combined treatment group (P < 0.01). The incidence of postoperative complications was significantly lower in the combined treatment group.Conclusion: Compared with phacoemulsification alone, the combined treatment regimen of intracameral anti-VEGF drugs and dexamethasone sustained-release implants is more effective in promoting the regression of neovascularization, controlling IOP and inflammation, improving visual acuity, and reducing postoperative medication use, demonstrating superior safety and overall efficacy.