Scleral Sutured Intraocular Lens Induced Scleritis
Published 2023 - 41st Congress of the ESCRS
Reference: CC01.01 | Type: Case report | DOI: 10.82333/qh2z-rv03
Authors: Abdulrahman Salem Albuainain* 1 , Wael Otaif 2 , Hatem Kalantan 2
1Eye & Laser center,Royal Medical Services, Bahrain Defence Force Hospital ,Riffa,Bahrain, 2College of Medicine,King Saud University ,Riyadh,Saudi Arabia
Purpose
To report a case of Scleral sutured intraocular lens (IOL) induced Severe Scleritis.
Setting
39 years old male medically free underwent scleral silk sutured IOL Pars Plana vitrectomy (PPV) with Gas for Traumatic Aphakia since childhood, then developed scleritis at suture sites, silk was replaced with Gore-Tex Sutures, scleritis progressed despite the Gore-Tex suture with extrusion of the Gore-Tex suture temporal then nasal sides, which was managed with oral steroid, immunosuppressant drugs and scleral patch graft.
Report of case
A 39 years old medically free gentleman presented to our institution with left eye pain and redness since his left eye surgery which was done elsewhere, in March 2021, underwent left eye scleral fixated (silk suture) IOL, PPV and Gas.
July 2021, diagnosed with surgery induced scleritis and was started in topical treatment, August 2021, underwent Gore-Tex suture replacing silk sutures nasal and temporal sides with Amniotic membrane patch graft, in December 2021 he was admitted under uveitis in our institution diagnosed with necrotizing scleritis, he was referred to Anterior Segment Service due to temporal extruded Gore-Tex suture, his ocular examination included visual acuity of 20/200, intraocular pressure 22 mmHg, upper lid swelling, conjunctival mild injection, 1 o’clock scleral thinning and active melting, anterior staphyloma covered by thin conjunctiva, extruded temporal Gore-Tex Knot without leak of fluorescein stain, nasal Gore-Tex knot was partially exposed, clear cornea, anterior chamber was deep with occasional cells, peaked pupil inferonasally, slightly temporal subluxation IOL, flat retina, healthy disc and macula.
Patient underwent a full uveitic work up, no systemic association was found, he was started on Systemic Steroid, immunosuppressive treatment, Topical steroids, antiglaucoma and antibiotics.
He underwent scleral patch graft of temporal extruded Gore-Tex suture, 6 months later nasal side was fully extruded and underwent for scleral patch graft in May 2022.
Conclusion/Take home message
Sight-threatening scleritis can occur after ocular surgery which can result in devastating destruction of the eye, promptly addressing the risk factors and treating the condition can safe the eye.