Case Report: Choroidal Detachment following Trabeculectomy in a 60-Year-Old Female with Type 2 Diabetes

Abstract

This case report describes a rare complication of choroidal detachment following trabeculectomy in a 60-year-old female with type 2 diabetes. The patient, on-compliant with her diabetes medication regimen, presented with elevated Intraocular Pressure (IOP) and glaucomatous optic neuropathy.

preoperative examination revealed open-angle glaucoma with a Shaffer grade of 30 degrees, optic nerve cupping, haemorrhage, and a cup-to-disc ratio greater than 0,7 Optical Coherence Tomography (OCT) confirmed non-proliferative diabetic retinopathy. trabeculectomy with an inverted scleral flap valve mechanism was performed under local anaesthesia. postoperatively, the patient experienced severe leakage from the surgical site, followed by choroidal detachment one-day post-surgery, presenting with blurred vision, scotoma, pain, photophobia, shallow anterior chamber, and low IOP (3mm HG). B scan ultrasonography revealed a large anterior, serous choroidal detachment. OCT showed choroidal thickening and hypo reflective areas consistent with fluid accumulation. initial management included a pressure patch, cycloplegics, intravenous fluids, and IOP-lowering medications.

Surgical intervention was also performed. close monitoring, close monitoring and follow-up examinations with IOP measurements, B scan, and OCT documented progressive resolution of the choroidal detachment over one year. Final assessment indicated complete resolution with stable IOP and no significant visual impairment. this case highlights the risk of choroidal detachment, particularly in patients with diabetes, even after seemingly uncomplicated trabeculectomy. it emphasizes the importance of meticulous surgical technique, vigilant postoperative monitoring, and prompt management to minimise vision- threatening complications.