Related Experiment Videos
Scleral necrosis and infection 15 years following pterygium excision
K G Au Eong1, P S Tseng, A S Lim
1Singapore National Eye Centre.
Abstract:
Scleral necrosis and infection are serious late complications of pterygium treatment and are difficult to manage. We describe a 70-year-old Chinese male who presented with scleral necrosis and Pseudomonas aeruginosa infection 15 years after the excision of a pterygium. The infection was treated early and aggressively with intensive topical and intravenous antibiotics and the thin necrotic sclera was reinforced with a donor scleral patch graft when the scleral infection was clinically controlled. The integrity of the globe was maintained by a thin layer of sclera anterior to the graft after the graft gradually shrunk in size and retracted posteriorly. The eye was saved from possible scleral perforation and endophthalmitis. This case is reported to highlight the importance of early aggressive treatment of infection and the value of prophylactic repair of scleral necrosis in the management of these late complications of pterygium treatment.
Insights
Scleral necrosis and Pseudomonas aeruginosa infection after pterygium surgery require aggressive treatment. A scleral patch graft successfully repaired necrosis, saving the eye from perforation.
Area of Science:
- Ophthalmology
- Surgical Complications
- Infectious Diseases
Background:
- Pterygium excision can lead to late complications, including scleral necrosis and infection.
- Scleral necrosis and infection post-pterygium surgery present significant management challenges.
Observation:
- A 70-year-old male developed scleral necrosis and Pseudomonas aeruginosa infection 15 years after pterygium excision.
- The patient presented with a thin, necrotic sclera requiring intervention.
Findings:
- Early and aggressive treatment with topical and intravenous antibiotics controlled the Pseudomonas aeruginosa infection.
- A donor scleral patch graft was used to reinforce the necrotic sclera once the infection was managed.
- The graft successfully maintained globe integrity, preventing perforation and endophthalmitis despite shrinkage.
Implications:
- This case underscores the critical need for prompt, aggressive antibiotic therapy for post-pterygium infectious complications.
- Prophylactic surgical repair of scleral necrosis is vital for preserving ocular integrity and preventing severe outcomes.
- Effective management strategies can salvage eyes affected by rare but serious late complications of pterygium treatment.