Kobtan H
Ophthalmology Department, Cairo University, Cairo, Egypt.
Eye (Lond). 2015 Apr;29(4):580-4. doi: 10.1038/eye.2014.327. Epub 2015 Jan 30.
Surgically induced scleral necrosis (SINS) is a severe form of scleritis threatening both vision and integrity of the eye. SINS is a rare sequel of ocular surgery and has been described after cataract extraction, trabeculectomy, strabismus, retinal detachment surgery including parsplana vitrectomy, penetrating keratoplasty, pterygium excision, and diode cyclophotocoagulation.
To report on the application of autologous fascia lata as a readily available natural biomaterial for ocular tectonic support in SINS, we performed this retrospective chart review including two eyes of two patients; one case following both repaired rupture globe, parsplana vitrectomy, and diode laser transscleral cyclophotocoagulation and one case following pterygium surgical excision.
Successful coverage of the area of scleral thinning with autologous fascia lata was achieved in both cases with overlying healthy vascularized conjunctiva and resolution of the ocular inflammation.
The fascia lata transplant combined with systemic immunosuppression was successful in providing adequate tectonic support and controlling the progression of scleral melt for two cases with SINS.
手术诱发的巩膜坏死（SINS）是一种严重的巩膜炎形式，威胁着视力和眼球的完整性。SINS是眼科手术罕见的后遗症，在白内障摘除术、小梁切除术、斜视手术、包括玻璃体切割术的视网膜脱离手术、穿透性角膜移植术、翼状胬肉切除术以及二极管睫状体光凝术后均有报道。
为了报告自体阔筋膜作为一种易于获取的天然生物材料在SINS中用于眼球结构支撑的应用情况，我们进行了这项回顾性病历审查，包括两名患者的两只眼睛；1例在修复眼球破裂、玻璃体切割术和二极管激光经巩膜睫状体光凝术后发生，另1例在翼状胬肉手术切除后发生。
两例均成功用自体阔筋膜覆盖巩膜变薄区域，上方有健康的血管化结膜，眼部炎症消退。
阔筋膜移植联合全身免疫抑制成功地为两例SINS患者提供了足够的结构支撑并控制了巩膜溶解的进展。
