title: Surgically induced necrotising sclerokeratitis (SINS)--precipitating factors and response to treatment.
abstract: The clinical features, treatment, and visual outcome of 52 eyes from 43 patients who developed scleritis following surgery were reviewed. In all patients the scleral inflammation developed adjacent to a surgical wound. Ninety six per cent had necrotising disease and 23% also had evidence of secondary posterior scleritis. Many different types of ocular surgery were implicated and the majority (75%) of the patients had two or more surgical procedures before the onset of the scleritis. Although cataract extraction through a limbal incision resulted in the largest subgroup, scleritis also followed glaucoma, strabismus, and retinal detachment surgery. The latent period between surgery and the appearance of inflammation was short (mean 9 months) except for a small group in whom scleritis occurred many years after squint surgery. Sixty three per cent of patients had evidence of a systemic disease. Early diagnosis and aggressive medical treatment significantly improved the visual outcome. The precipitating factors, pathogenesis, and course of this condition are discussed.
authors.affiliation: Department of Clinical Ophthalmology, Moorfields Eye Hospital, London.
authors.forename: E
authors.initials: E
authors.lastname: O'Donoghue
authors.forename: S
authors.initials: S
authors.lastname: Lightman
authors.forename: S
authors.initials: S
authors.lastname: Tuft
authors.forename: P
authors.initials: P
authors.lastname: Watson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002387:Cataract Extraction; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D015985:Precipitating Factors; D012307:Risk Factors; D012590:Sclera / Q000473:pathology; D015423:Scleritis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D013285:Strabismus / Q000601:surgery
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal