4 Cases of Pseudomonas Scleritis after Pterygium Excision

ABSTRACT

It is known that the treatment of pseudomonas aeruginosa infection associated with scleral necrosis after pterygium excision is difficult. Pseudomonas scleritis were treated with systemic and topical antibiotics, debridement, scleral homograft,and conjunctival autograft in 3 cases of 4 cases. Another 1 case was transfered to other hospital with patient`s request after short medical treatment. The interval from pterygium operation to onset of pseudomonas scleritis ranged from 2 to 17 years with an average of 10 years. In all cases with operation, the graft was stabilized after mean time of 42 days (ranged 35 to 48 days) from operation. The complications were visual disturbance, endophthalmitis, complicated cataract, exudative retinal detachment, exotropia, and posterior synechia of iris. In 1 case, a corticosteroid which was used in the early of treatment induced exacerbation of disease.Because the complications of disease were so severe,early prophylactic operation will be necessary in noninfected scleral necrosis, and when infection is suspected, it should be necessary to do culture and sensitivity test with an intensive anti-pseudomonal therapy.