A New Approach For Management Of Surgically Induced Necrotizing Scleritis With Umbilical Cord Amniotic Membrane Implantation

Published 2025 - 43rd Congress of the ESCRS

Reference: PO191 | Type: Case Report | DOI: 10.82333/kffe-ss83

Authors: Oğuzhan Karabulut* ¹ , Sibel AHMET ¹ , NILAY KANDEMIR BESEK ¹ , Rukiye AYDIN ARSLAN ² , Husna TOPCU ³ , Ahmet KIRGIZ ¹ , Kubra Serefoglu CABUK ⁴

¹BEYOGLU EYE TRAINING AND RESEARCH HOSPITAL,ISTANBUL,Türkiye, ²IZMIR SEHIR HASTANESI,IZMIR,Türkiye, ³OSMANGAZI EYE CENTER,BURSA,Türkiye, ⁴PRIVATE PRACTICE,ISTANBUL,Türkiye

Purpose

To present the surgical management of surgically induced necrotizing scleritis (SINS) patient, highlighting the successful use of umbilical cord amniotic membrane (UCAM) for ocular surface reconstruction and conjunctival epithelialization.

Setting

This study is a retrospective case report from the Cornea Unit of Beyoğlu Eye Training and Research Hospital, a tertiary referral center in Istanbul, Turkey.

Report of case

A 58-year-old male patient presented with redness in the left eye. He had a history of cataract surgery (25 years ago) and retinal detachment surgery with a scleral buckle (17 years ago). Visual acuity was 20/20 (right) and 20/50 (left). Examination revealed an exposed solid silicone scleral buckle due to conjunctival erosion, with no purulent secretions. Systemic workup showed diabetes (HbA1c: 7.2%). The buckle was removed, and the scleromalacic area was covered with pericardial patches and amniotic membrane (AM). Due to incomplete epithelialization, scleral patches and umbilical cord AM (UCAM) were implanted. By the second month, UCAM was removed, showing vascularized scleral patches with complete conjunctival healing. The patient remains on methylprednisolone with a planned dose reduction, and partial lateral tarsorrhaphy was performed for ocular protection.

Conclusion/Take home message

This case highlights the effectiveness of UCAM in promoting vascularization and conjunctival epithelialization, offering a viable option for complex ocular surface reconstructions either as a primary or secondary approach. Long-term monitoring and careful systemic management, particularly in surgically induced necrotizing scleritis (SINS) patients, are crucial for optimal outcomes.