Progressive Corneo-Scleral Dellen With Uveal Exposure Following Pterygium Excision
Published 2026 - 44th Congress of the ESCRS
Reference: POCOR110 | Type: Case Report | DOI: 10.82333/3s1c-vg83
Authors: Dr Aparna Namdev Nayak* 1 , Dr Krishna Prasad Kudlu 2 , Dr Sanjana Vatsa 3
1Cornea and Phaco refractive,Prasad Netralaya,Udupi,India, 2Phaco refractive,Prasad Netralaya,Udupi,India, 3Cornea and Phaco refractive,Agarwals Eye Hospital,bengaluru,India
Purpose
To report a rare case of Corneoscleral dellen with uveal exposure following pterygium excision, identify contributory postoperative factors, and describe successful surgical management using multilayer amniotic membrane grafting combined with conjunctival autograft.
Setting
Tertiary eye care centre in South India specializing in corneal, ocular surface, and anterior segment surgery.
Report of case
A 45-year-old male presented with redness and foreign body sensation in the right eye two weeks after pterygium excision. He was a driver by occupation and resumed driving from the first postoperative day and reported poor compliance with protective eyewear and topical medications. Best-corrected visual acuity was 6/6.
Slit-lamp examination showed a localized corneal dellen at the 3 o’clock limbal area with adjacent nasal conjunctival retraction. The eye was pseudophakic, intraocular pressure was 17 mmHg and fundus examination was normal. The left eye had grade 2 pterygium with early senile cataract.
Despite intensive preservative-free lubricants, gel and systemic doxycycline, progression to corneoscleral dellen measuring 3×3 mm with scleral thinning and localized uveal exposure was noted on follow up. Systemic evaluation for autoimmune disease was negative.
Given the risk of perforation, multilayered amniotic membrane grafting was performed to fill the defect, followed by conjunctival autograft to restore surface integrity. Postoperatively, tectonic stability was achieved and the ocular surface healed satisfactorily with preserved visual acuity.
Conclusion/Take home message
Postoperative dellen after pterygium surgery may progress to sight-threatening scleral dellen and uveal exposure, particularly in cases of conjunctival retraction or previous pterygium excision with bare sclera technique and poor compliance. Early recognition is critical. Multilayer amniotic membrane grafting combined with conjunctival autograft provides effective tectonic support, restores surface integrity, and prevents perforation while preserving vision.