Serous Retinal Detachment Following Bleb Needling

Transconjunctival bleb needling is a relatively simple and effective procedure used to restore aqueous humor outflow in failing trabeculectomy blebs. Although generally considered safe, several complications have been reported, including bleb leakage, hypotony, and choroidal effusion. We report a case of nonrhegmatogenous serous retinal detachment following transconjunctival bleb needling in a 56-year-old man with diabetes, Fuchs heterochromic iridocyclitis, and secondary glaucoma who underwent the procedure for an encapsulated bleb after trabeculectomy. The patient developed persistent serous retinal detachment postoperatively, which was successfully managed with Pars plana vitrectomy. Although serous retinal detachment has been reported after glaucoma filtration surgery, this complication following transconjunctival bleb needling has rarely been described. The underlying mechanism is likely multifactorial, involving mechanical, inflammatory, and ischemic factors. Clinicians should be aware of this rare complication and include it in preoperative counseling.