Aim: The aim of this article is to present a clinical case of a postoperative complication of pterygium surgery—surgically induced necrotizing scleritis with corneal ulcer, and to propose a diagnostic and therapeutic algorithm.
Materials and Methods: The case refers to a woman with pterygium who underwent a thorough preoperative ophthalmological examination. We examined: visual acuity, tonometry, biomicroscopy, funduscopy, corneal topography, and performed frontal photography of the anterior segment and nasal abduction of the eye bulb. A technique of simple closure of the conjunctiva without antiproliferative agent was used. Postoperatively, the patient was followed up on the first and tenth days, as well as the first, second, and third months. The accompanying documentation was analyzed—video documentation, paraclinical examinatiоn, B-scan, and photo documentation.
Results: On the tenth postoperative day, we found corneal and scleral ulcer. On the 28th postoperative day, a development in the condition was observed—an increase in the area and depth, mainly of the scleral ulcer. A diagnosis of necrotizing scleritis was made. An effective treatment was done, with the so-called soft steroid—loteprednol etabonate, and epithelializing eye drops and gels. It resulted in halting the necrosis and preventing the risk of bulbar perforation.
Conclusion: Although a rare complication after pterygium surgery, necrotizing scleritis should be considered in any surgery and appropriate measures should be taken to prevent this sight-threatening postsurgical complication.
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