title: Severe scleral dellen as an early complication of pterygium excision with simple conjunctival closure and review of the literature.
abstract: We describe a patient with acute scleral dellen (SD) after pterygium excision with simple conjunctival closure. In addition, we present a PUBMED review on the medical literature on early SD after pterygium surgery. This case describes a 45-year-old man who presented with severe SD, 7 days after pterygium surgery with minimal cauterization of episcleral vessels and simple conjunctival closure.No other adjunctive therapy was used intraoperatively. The patient refused conjunctival flap coverage of the lesion. Therefore, medical treatment consisted of antibiotic ointment, patching, and daily follow-up. After 7 days, the patching was changed for intensive ocular lubrication. Five weeks later, the surrounding conjunctive had completely covered the affected sclera. To the best of our knowledge, this is the first report of early SD following pterygium excision and simple conjunctival closure with no other adjunctive therapy. When performing pterygium excision with conjunctival coverage of the sclera, a close follow-upis recommended to rule out wound dehiscence and SD, even when surgical wound closure is considered to prevent
authors.affiliation: Department of Ophthalmology, General University Hospital Reina Sofia, Murcia, Spain.
authors.forename: Jose Javier
authors.initials: JJ
authors.lastname: Garcia-Medina
authors.affiliation: Department of Anesthesia, University Hospital La Arrixaca, Murcia, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Del-Rio-Vellosillo
authors.affiliation: Ophthalmology Research Unit "Santiago Grisolia", Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Zanon-Moreno
authors.affiliation: Department of Ophthalmology, General University Hospital Reina Sofia, Murcia, Spain.
authors.forename: Amanda
authors.initials: A
authors.lastname: Ortiz-Gomariz
authors.affiliation: Department of Ophthalmology, General University Hospital Reina Sofia, Murcia, Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Morcillo-Guardiola
authors.affiliation: Ophthalmology Research Unit "Santiago Grisolia", Valencia, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Pinazo-Duran
mesh_terms: D003228:Conjunctiva / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011625:Pterygium / Q000601:surgery*; D012590:Sclera / Q000473:pathology / Q000601:surgery; D015422:Scleral Diseases / Q000209:etiology* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome