Amniotic membrane transplantation in surgically induced necrotizing scleritis with peripheral ulcerative keratitis

Abstract

A case of surgically induced necrotizing scleritis (SINS) after manual small incision cataract surgery that was associated with peripheral ulcerative keratitis (PUK) at a different site. Neither pathology responded to systemic steroids and progressed to become sight threatening, which is unusual. Progression of SINS was aggressive enough to cause a limbal wound gape, similarly PUK extended up to Descemet's membrane and emergency amniotic membrane transplantation (AMT) was required to save the globe. AMT may regress the scleral and corneal melting successfully. It is not common to observe SINS with PUK at a different site that is unresponsive to systemic steroids. AMT, though palliative treatment, was effective at treating this condition successfully.

Necrotizing scleritis after pterygium excision with fibrin glue–fixated conjunctival autograft in Behcet’s disease

“…In our case, SINS did not respond to local and asystemic steroid therapy, which was reported in a previous similar case study. 14 Amniotic membrane transplantation was previously reported to be successful in reducing inflammation and in preventing globe perforation. 15 An amniotic membrane was transplanted over this conjunctival advancement flap and over the adjacent cornea, with the epithelial side up.…”