Agarwal Manisha, Ranjan Richa, Mathur Umang
Dr. Shroff's Charity Eye Hospital, 5027-Kedar Nath Road, Daryaganj, New Delhi, 110002, India.
J Ophthalmic Inflamm Infect. 2020 Jan 27;10(1):3. doi: 10.1186/s12348-020-0197-4.
Subtenon triamcinolone acetonide injection (STAI) is a safe drug delivery method for various ocular conditions. We report two cases of necrotic scleral melt, a rare complication of STAI.
The first patient received STAI for post-operative inflammation control and developed necrotic scleral melt at the site of STAI with superadded fungal keratitis. The second patient received three STAI for non-necrotizing, non-infectious anterior scleritis and developed scleral necrosis at the site of her last STAI. Noncompliance with medications resulted in the progression of scleral necrosis to a new area.
In the first patient, surgical removal of triamcinolone deposit resulted in healing of the scleral melt while the second patient was managed conservatively with corticosteroids and immunosuppressants.
Scleral melt is a rare complication of STAI; however, an early diagnosis and management of any predisposing factor along with surgical debridement should be considered as a potential critical treatment option to salvage the eye.
球周曲安奈德注射（STAI）是一种用于多种眼部疾病的安全给药方法。我们报告两例坏死性巩膜融解病例，这是STAI一种罕见的并发症。
首例患者接受STAI以控制术后炎症，并在STAI注射部位发生坏死性巩膜融解，同时合并真菌性角膜炎。第二例患者接受三次STAI治疗非坏死性、非感染性前巩膜炎，在其最后一次STAI注射部位发生巩膜坏死。未遵医嘱用药导致巩膜坏死向新区域进展。
首例患者手术清除曲安奈德沉积物后巩膜融解愈合，而第二例患者采用皮质类固醇和免疫抑制剂进行保守治疗。
巩膜融解是STAI的一种罕见并发症；然而，早期诊断和处理任何易感因素以及手术清创应被视为挽救眼球的潜在关键治疗选择。
