AIM:Cataract surgery techniques have improved a lot over the years. The present study was designed to propose a novel and surgically easy technique of ‘in the tunnel’ trabeculectomy with lesser incidence of complications in the management of cataract with primary open angle glaucoma (POAG). METHODS:One hundred and three patients were included in a prospective, nonrandomized clinical study. 108 eyes of 103 patients with POAG and cataract were performed manual small incision cataract surgery (MSICS) combined with ‘in the tunnel’ trabeculectomy. The outcome of the surgery was evaluated in terms of the anatomical appearance of the bleb and its functional result over a period of 6 months.RESULTS:The mean intraocular pressure (IOP) on the first postoperative day was 11.4±3.1mmHg in the tunnel incision group (P=0.012). On the second postoperative day the mean IOP was 10.3±3.5mmHg (P =0.065). Shallow anterior chamber and iridocorneal touch occurred significantly less in the tunnel incision group. CONCLUSION:"Scleral tunnel incision"-trabeculectomy (STIT) appears to be steady lowering IOP during the first 6 months postoperatively. It is also relatively safe and has fewer early complications related to excessive aqueous outflow than conventional trabeculectomy (CT).