Keratectasia as a presentation of surgically induced necrotizing sclerokeratitis (SINS).
OBJECTIVE
A case of keratectasia is reported as a severe presentation of surgically induced necrotizing sclerokeratitis (SINS).


METHODS
A 72-year-old white woman had a painful, raised lesion on the superior cornea of her right eye 3 years after uncomplicated extracapsular cataract extraction with intraocular lens implantation. Examination showed a large ectatic area of the superior cornea with inflamed sclera adjacent to the surgical wound, which was diagnosed as SINS.


RESULTS
No underlying systemic autoimmune condition or vasculitis was identified on investigation. Progressive painful keratectasia necessitated enucleation, which confirmed on histopathologic examination features of chronic nodular episcleritis and nongranulomatous scleritis with evidence of keratitis and fibrovascular scarring.


CONCLUSIONS
The predominant inflammatory response in the cornea represents surgically induced necrotizing keratoscleritis (SINK) as a new variant presentation of SINS. Oral corticosteroids and immunosuppressive agents should not be delayed to prevent progressive tissue destruction and poor outcome.
Nguyen
Dan Q
DQ
Bristol Eye Hospital, Bristol, United Kingdom. danqbnguyen@hotmail.com
Raman
Vasant S
VS
Twomey
John M
JM
Luthert
Phil
P
D000368:Aged; D002387:Cataract Extraction / Q000009:adverse effects*; D003316:Corneal Diseases / Q000209:etiology* / Q000473:pathology; D004108:Dilatation, Pathologic / Q000209:etiology; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D007634:Keratitis / Q000150:complications* / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D015423:Scleritis / Q000150:complications* / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery