Serous retinal detachment after trabeculectomy in angle recession glaucoma

Area of Science:

• Ophthalmology
• Glaucoma Research
• Surgical Complications

Background:

• Angle recession glaucoma resulting from blunt ocular trauma can lead to uncontrolled intraocular pressure (IOP).
• Standard medical management with multiple antiglaucoma medications (AGM) may be insufficient for severe cases.
• Surgical intervention, such as trabeculectomy with mitomycin-c (MMC), is considered for refractory glaucoma.

Observation:

• An 18-year-old male presented with uncontrolled IOP and disc damage secondary to 360-degree angle recession.
• Trabeculectomy with MMC was performed, complicated by intraoperative vitreous prolapse.
• Postoperatively, the patient developed shallow choroidal detachment progressing to serous retinal detachment with non-recordable IOP.

Findings:

• Systemic and topical steroid administration led to the resolution of serous effusions within two weeks.
• At three months post-surgery, the patient achieved good visual acuity, normalized IOP without AGM, and attached retina.
• The case demonstrates a rare but significant complication of serous retinal detachment after glaucoma surgery for angle recession.

Implications:

• This case underscores the importance of vigilant monitoring for rare complications after glaucoma surgery.
• Early recognition and prompt management, including steroid therapy, are crucial for favorable outcomes in such cases.
• Further research into the mechanisms and prevention of serous retinal detachment post-trabeculectomy may be warranted.