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How to overcome the dreaded SINS, which can follow pterygium surgery?

Poster Details

First Author: T.Chowdhury INDIA

Co Author(s):    M. Das   N. Das           

Abstract Details



Purpose:

To evaluate the visual and structural outcomes in the management of 11 patients with surgically induced necrotizing scleritis (SINS) following pterygium surgery.

Setting:

Disha Eye Hospitals, Barrackpore, Kolkata, India

Methods:

The study was a retrospective, non-comparative, interventional case series. All patients underwent pterygium surgery elsewhere and then referred to our centre. The time interval of primary pterygium surgery and referral to our centre was 2 weeks to 4 months. All cases had bare sclera technique of pterygium surgery . No patients were treated by any adjuvant mitomycin C/ thiotepa or beta irradiation by the primary surgeon.

Results:

8 eyes needed tectonic patch graft after debridement of all the devitalized tissue, 2 eyes needed amniotic membrane graft (AMG) and one eye improved with conservative management by lubricants and NSAIDS. No patients had any systemic illness or collagen vascular disorders. The follow up ranged from 3 months to 32 months. 10 eyes had good structural outcomes and one eye developed endophthalmitis which needed evisceration. Visual acuity improved in 7 eyes and remained stable in 3 eyes.

Conclusions:

We feel that local ischemia and excessive use of cautery is the cause for scleral necrosis especially in these bare sclera technique of pterygium surgery. Though SINS is a rare and most dreadful postoperative complication following pterygium surgery,timely diagnosis and early surgical intervention has good visual and structural outcomes in most cases. FINANCIAL INTEREST: NONE

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