Surgical Management of Scleral Necrosis

ABSTRACT

Scleral necrosis is a focal thinning of the sclera, and causes an exposure of underlying uveal tissue, endophthalmitis, and eyeball perforation. The authors experienced 16 cases of scleral necrosis after pterygium excision and performed combined lamellar scleral grafting and conjunctival flap for 13 cases, and simple conjunctival flap for 3 cases. After 12 months of follow-up period, all of the scleral grafts healed well except one case of graft melting. Six cases associated with endophthalmitis showed three lines of mean visual acuity improvement with Snellen chart after postoperative healing of inflammation. Postoperative complications included temporary corneal erosion(6 cases), conjunctival cyst formation(2 cases), scleral graft melting(1 case), and partial absorption of conjuctival flap(1 case).