The purpose of this brief report is to report on the outcome of glaucoma management in children after pars plana vitrectomy (PPV) in Alexandria Main University hospital. The Medical records of children presenting with glaucoma after PPV were reviewed. Data extracted included patients' demographic data, antenatal, natal and postnatal history, indication for PPV and surgical details, details of glaucoma surgery, clinical preoperative and postoperative follow up. Success of glaucoma surgery was defined as an IOP ≤ 16 mmHg and ≥ 20% reduction from the presenting IOP. The study included 9 eyes of 8 children, that had undergone PPV for ROP (6 eyes) and vitreous haemorrhage (3 eyes). All study eyes were subjected to combined trabeculectomy-trabeculotomy with Mitomycin C. The mean ± standard deviation of the age at glaucoma surgery and follow up duration were 7.9±4.43 and 11.1±10.0 months respectively. The mean ± standard deviation of the preoperative and last visit IOP and C/D ratio were 22.9±6.9 mmHg, 0.8±0.2, 16.9±5.8 mmHg (P=0.063) and 0.4±0.3 (P=0.036) respectively. The success rate at final follow up was 55.6%. In this study, glaucoma after PPV has a poor prognosis and does not generally respond to combined filtering and angle surgery.

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 non-rhegmatogenous 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.