Madanagopalan V G, Shivananda Narayana, Krishnan Thiruvengadakrishnan
Vitreo-Retinal Services, Aravind Eye Hospital, Pondicherry, India.
Cornea Services, Aravind Eye Hospital, Pondicherry, India.
GMS Ophthalmol Cases. 2019 May 29;9:Doc18. doi: 10.3205/oc000107. eCollection 2019.
Scleral necrosis is a rare occurrence after many ocular procedures. In the absence of infection or use of surgical adjuncts such as antimetabolites or radiation, the necrosis is presumed to be directly related to surgical trauma and is hence termed surgically induced necrotizing scleritis (SINS). A high index of suspicion is required for an early diagnosis of SINS and its differentiation from infective scleritis is important as the treatment modalities of these two related conditions are different. We report a case of SINS at sclerotomy site following 23-gauge transconjunctival retinal detachment surgery that was initially suspected to be a scleral abscess. Prompt recognition and institution of topical and systemic steroid therapy helped in limiting the extent of scleral damage.
巩膜坏死在许多眼科手术后很少发生。在没有感染或未使用抗代谢药物或放射等手术辅助手段的情况下，坏死被认为与手术创伤直接相关，因此被称为手术诱发的坏死性巩膜炎（SINS）。早期诊断SINS需要高度的怀疑指数，并且将其与感染性巩膜炎区分开来很重要，因为这两种相关病症的治疗方式不同。我们报告了一例23G经结膜视网膜脱离手术后巩膜切开部位发生SINS的病例，该病例最初被怀疑为巩膜脓肿。及时识别并给予局部和全身类固醇治疗有助于限制巩膜损伤的程度。
