Objective The Aurolab aqueous drainage implant (AADI) has the potential advantages of less encapsulation and greater cost-effectiveness than the Ahmed glaucoma valve (AGV). The aim of this study was to compare the surgical success and outcomes of the AADI compared to the AGV in Middle-Eastern children. Methods A comparative retrospective study of consecutive paediatric patients in a tertiary eye hospital was undertaken. Data collected included demographics, type of glaucoma, intraocular pressure (IOP), number of anti-glaucoma medications (AGMs) and any subsequent complications or further surgeries. Analysis The mean IOP, number of AGMs, surgical success and number of reoperations was compared for the two groups. Surgical success at each visit was defined as IOP of ≥6 mm Hg and ≤21 mm Hg or if the reduction of IOP was ≥20% reduced from baseline. Results A total of 126 tube surgeries (56 eyes in AADI and 70 eyes in AGV) were performed in patients aged ≤18 years from 2014 to 2019. No difference was observed in the mean IOP between the two groups except at the first month post-operative visit. After six months, the AADI group had a consistently significant lower mean number of AGMs. At last follow-up, 21 (37.5%) eyes in the AADI group were glaucoma medication-free vs 15 (21.4%) eyes in the AGV group (pp=0.047). Kaplan-Meier analysis showed equivalent cumulative probability of success at two years of 69.9% [(45.9%–84.9%)] for AADI vs 66.8% [(53.4%–77.1%])) for the AGV, respectively. Twenty-four eyes in the AGV group needed one or more subsequent surgeries, whereas 13 eyes needed one or more surgery in the AADI group. Conclusions This study shows an acceptable safety profile for the AADI in children, with a rate of failure that is comparable to the AGV, but less need for glaucoma re-operation or glaucoma medication in the first post-postoperative year.

Purpose: To evaluate the outcomes of one muscle recession for horizontal comitant strabismus at a major referral hospital in the Middle East. Method: Retrospective charts review of postoperative outcomes of 90 patients who had undergone one muscle recession for small to moderate angle esotropia or exotropia. Data were collected for age, vision, amblyopia, previous surgery or botulinum toxin injection, preoperative deviation, amount and type of one muscle surgery, and postoperative deviation at the initial and last (six months or more) postoperative visit. Successful alignment was defined as +/- 10 prism diopters (PD) of orthophoria. Results: Sixty patients underwent medial rectus recession and 30 patients underwent lateral rectus recession. The average preoperative and last follow up deviation -respectively- was 24 +/- 6.1 PD (15-35) PD and 14.62 +/- 8.91 PD in the medial rectus recession group and 21.3 +/- 5.1 PD (12-30) and 12.60 +/- 8.74 in the lateral rectus recession group. The final success rates were 63.3% in both groups. Conclusion: Single muscle strabismus surgery to correct horizontal strabismus had a variable outcome. Larger recession may help in achieving better outcomes. Properly designed prospective studies may help in identifying the factors affecting the outcomes of single muscle strabismus surgeries.

Retinoblastoma is a rare but malignant pediatric retinal tumor, affecting 1 in 15,000–20,000 live births annually. It arises from biallelic mutations in the RB1 tumor suppressor gene (chromosome 13q14.2), leading to uncontrolled cell cycle progression. Clinically, it presents as unilateral (60%) or bilateral (40%) disease, with leukocoria and strabismus as hallmark signs. Untreated, retinoblastoma is fatal due to metastatic spread. The disease follows Knudson’s two-hit model: heritable forms (30–40% of cases) involve a germline RB1 mutation (M1) and a somatic second hit (M2), predisposing to bilateral/multifocal tumors and secondary cancers. Non-heritable cases (60–70%) result from somatic RB1 mutations or, rarely, MYCN amplification (2%). Genetic testing is critical to classify risk (H0, H1, and HX categories), guide surveillance, and inform family counseling. Bilateral cases almost always harbor germline mutations, while 15% of unilateral cases may carry germline/mosaic RB1 defects. Advanced techniques (Sanger/NGS sequencing for mutation detection, NGS for copy number alterations, and methylation assays) detect RB1 mutations, CNVs, and epigenetic silencing. Tumor DNA analysis resolves ambiguous cases. H1 patients require intensive ocular and brain MRI surveillance, while H0 cases need no follow-up. Prenatal/preimplantation genetic diagnosis (PGD) can prevent transmission in high-risk families. Emerging research explores additional genes (BCOR, CREBBP) and MYCN-amplified subtypes. Genetic counseling addresses recurrence risks, reproductive options, and long-term cancer monitoring. Integrating genetic insights into clinical practice enhances precision medicine, reducing morbidity and healthcare costs. Future directions include whole-genome sequencing and functional studies to refine therapeutic strategies.

Purpose: To evaluate the clinical characteristics, management strategies, and surgical outcomes of tractional and/or rhegmatogenous retinal detachment (TRD/RRD) in eyes with retinoblastoma (RB). Methods: A retrospective surgical case series of patients with treated RB at a tertiary referral center (June 2014–April 2025) who developed non-exudative retinal detachment (RD) was conducted. The data included demographics, tumor activity, RB treatment modalities received, RD features, surgical approach, complications, anatomical reattachment, and final visual acuity. Results: Seven eyes of seven patients (0.9%) developed TRD or RRD. Four eyes had RRD, two had combined RRD/TRD, and one had TRD. Early RRD during active RB was treated with nondrainage scleral buckling ( n = 2), whereas late detachments after complete tumor regression underwent pars plana vitrectomy with silicone oil tamponade ( n = 4). Anatomical reattachment at one year was achieved in 83.3% of the operated eyes (five of six eyes undergoing surgery), with no cases of tumor seeding or reactivation observed. One eye was enucleated due to tumor progression. Visual acuity improved to baseline or better in 71.4% of the eyes. Conclusions: In this small series, early RRD during active RB was managed with nonsurgical scleral buckling without evidence of tumor dissemination, and late complex RRD after confirmed tumor quiescence was treated with pars plana vitrectomy and silicone oil tamponade with favorable anatomical outcomes. No tumor seeding or reactivation was observed in any case. However, these findings should be interpreted with caution, given the small sample size, and do not allow definitive conclusions regarding oncologic safety.