Corneal Dellen and Scleral Melt Induced following Phacoemulsification Surgery and Bare Sclera Pterygium Excision: A Case Report

Abstract

Scleral thinning and delayed conjunctival regeneration can be found after bare sclera pterygium excision. A 63-year-old male was admitted at our department for a left eye cataract and grade II nasal pterygium in the same sitting. Pterygium excision was done without putting graft or adjuvant treatment. After two weeks of surgery, the patient presented with scleral thinning and corneal dellen at the site of the pterygium excision. The scleral thinning was deep enough to show the uveal tissue through its base. Successful management was done with topical and oral medications for six weeks. Bare sclera pterygium excision should not be practiced along with cataract surgery. It should be performed in two different sittings, or conjunctival autograft or amniotic membrane graft should cover the bare area. Steroid drops may also slow healing and induce iatrogenic sclera necrosis leading to dreaded consequences.

Keywords

• autoimmune disease
• phacoemulsification
• pterygium
• sclera
• scleral disease