H Kobtan1. 1. Ophthalmology Department, Cairo University, Cairo, Egypt.
Abstract
BACKGROUND: Surgically induced scleral necrosis (SINS) is a severe form of scleritis threatening both vision and integrity of the eye. SINS is a rare sequel of ocular surgery and has been described after cataract extraction, trabeculectomy, strabismus, retinal detachment surgery including parsplana vitrectomy, penetrating keratoplasty, pterygium excision, and diode cyclophotocoagulation. MATERIALS AND METHODS: To report on the application of autologous fascia lata as a readily available natural biomaterial for ocular tectonic support in SINS, we performed this retrospective chart review including two eyes of two patients; one case following both repaired rupture globe, parsplana vitrectomy, and diode laser transscleral cyclophotocoagulation and one case following pterygium surgical excision. RESULTS: Successful coverage of the area of scleral thinning with autologous fascia lata was achieved in both cases with overlying healthy vascularized conjunctiva and resolution of the ocular inflammation. CONCLUSION: The fascia lata transplant combined with systemic immunosuppression was successful in providing adequate tectonic support and controlling the progression of scleral melt for two cases with SINS.
BACKGROUND: Surgically induced scleral necrosis (SINS) is a severe form of scleritis threatening both vision and integrity of the eye. SINS is a rare sequel of ocular surgery and has been described after cataract extraction, trabeculectomy, strabismus, retinal detachment surgery including parsplana vitrectomy, penetrating keratoplasty, pterygium excision, and diode cyclophotocoagulation. MATERIALS AND METHODS: To report on the application of autologous fascia lata as a readily available natural biomaterial for ocular tectonic support in SINS, we performed this retrospective chart review including two eyes of two patients; one case following both repaired rupture globe, parsplana vitrectomy, and diode laser transscleral cyclophotocoagulation and one case following pterygium surgical excision. RESULTS: Successful coverage of the area of scleral thinning with autologous fascia lata was achieved in both cases with overlying healthy vascularized conjunctiva and resolution of the ocular inflammation. CONCLUSION: The fascia lata transplant combined with systemic immunosuppression was successful in providing adequate tectonic support and controlling the progression of scleral melt for two cases with SINS.