Two Cases of Necrotizing Scleritis After Pars Plana Vitrectomy

ABSTRACT

Necrotizing scleritis is an uncommon but most severe form in scleritis both in terms of pain and scleral destruction. It occasionally associated with systemic connective tissue diseases or idiopathic in orgin. Adequate diagnosis and therapy are essential to every ophthalmologist because it takes disastrous clinical course frequently. Histopathologically, localized granulomatous vasculitis was found and in pathogenesis, immunologic mechanism is suggested. We treated two cases of necrotizing scleritis which developed after pars plana vitrectomy, with topical or systemic corticosteroids and in one case, whose sclera was extensively melted, grafting with fascia lata was made with sucessful result. Two eyes became quiet after months of treatment without sequelae by scleritis itself We thought that this conditions occured by electrical low current diathermy which was given for hemostasis around sclerotomy incisions and by diabetic microcirculatory disturbances although not proven histologically.