title: Surgically induced necrotizing scleritis after pterygium surgery with conjunctival autograft.
abstract: OBJECTIVE
  To report a case of surgically induced necrotizing scleritis (SINS) as a complication of conjunctival autograft after pterygium excision.
  
  
  METHODS
  A 52-year-old man had undergone nasal pterygium excision with conjunctival autograft in the right eye at another facility. He was treated for suspected infective scleritis before presentation.
  
  
  RESULTS
  The sclera, at the site of prior pterygium excision, showed significant thinning with uveal show. There was active inflammation adjacent to the site of thinning. Systemic studies and the examination were noncontributory. The patient was suspected of having SINS and received pulsed injections of methylprednisolone 1000 mg/d for 3 days. The patient also underwent an emergency scleral patch graft with amniotic membrane graft. Over the next 2 weeks, the scleral graft showed vascularization and was taken well.
  
  
  CONCLUSIONS
  SINS may develop after pterygium surgery with conjunctival autograft. Evidence of connective tissue disease may or may not be found on clinical examination and on laboratory studies. Early diagnosis, prompt immunosuppression, and scleral patch grafting prevents progression and further devastating complications.
authors.affiliation: Department of Cornea and External Diseases, Aditya Jyot Eye Hospital Pvt Ltd, Wadala, Mumbai, India. docvandanajain@rediffmail.com
authors.forename: Vandana
authors.initials: V
authors.lastname: Jain
authors.forename: Debraj
authors.initials: D
authors.lastname: Shome
authors.forename: Sundaram
authors.initials: S
authors.lastname: Natarajan
authors.forename: Rohit
authors.initials: R
authors.lastname: Narverkar
mesh_terms: D000650:Amnion / Q000637:transplantation; D003228:Conjunctiva / Q000637:transplantation*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011183:Postoperative Complications; D011625:Pterygium / Q000601:surgery*; D012590:Sclera / Q000637:transplantation; D015423:Scleritis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D014182:Transplantation, Autologous
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone