1/11. Surgically induced necrotizing scleritis in a patient with ankylosing spondylitis.We present the case of a 75-year-old man with ankylosing spondylitis who developed surgically induced necrotizing scleritis (SINS) more than 3 years after uneventful extracapsular cataract extraction and posterior chamber intraocular lens implantation. The patient presented with a painful eye and increasing vertical diplopia. To our knowledge, neither the association of SINS and ankylosing spondylitis nor vertical diplopia as its presenting complaint has been described.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/11. haemophilus influenzae associated scleritis.AIMS: To describe the clinical course and treatment of haemophilus influenzae associated scleritis. methods: Retrospective case series. RESULTS: Three patients developed scleritis associated with ocular H influenzae infection. Past medical history, review of systems, and laboratory testing for underlying collagen vascular disorders were negative in two patients. One patient had arthritis associated with an antinuclear antibody titre of 1:160 and a Westergren erythrocyte sedimentation rate of 83 mm in the first hour. Each patient had ocular surgery more than 6 months before developing scleritis. Two had cataract extraction and one had strabismus surgery. Nodular abscesses associated with areas of scleral necrosis were present in each case. culture of these abscesses revealed H influenzae in all patients. Treatments included topical, subconjunctival, and systemic antibiotics. Scleral inflammation resolved and visual acuity improved in each case. CONCLUSION: H influenzae infection may be associated with scleritis. Accurate diagnosis and treatment may preserve ocular integrity and good visual acuity.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/11. Postoperative necrotizing sclerokeratitis.The postoperative necrotizing sclerokeratitis is a rare condition occurring shortly after surgical procedures, mainly following cataract extractions. After several exacerbations and remissions spontaneous scleral perforation may occur. In the described case the conservative treatment/topical antibiotics, corticosteroids/failed, therefore the damaged scleral surface was covered with lyophilized dura and the condition came to a standstill.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/11. Necrotizing scleritis after intraocular surgery associated with the use of polyester nonabsorbable sutures.We present 2 elderly patients who developed necrotizing scleritis after cataract extraction in which the wound was sutured with polyester. In the first case, a 73-year-old woman who had right phacoemulsification via a limbal incision developed necrotizing scleritis 8 months after surgery. The eye became progressively painful and phthisical, necessitating enucleation. Microscopic examination of the enucleated globe showed a predominantly lymphocytic infiltration of the ocular tissues with no evidence of an infectious agent. In the second case, a 78-year-old woman had bilateral extracapsular cataract extraction through a limbal incision closed with a polyester suture. The patient presented 3 years later with bilateral necrotizing sclerokeratitis. No underlying systemic vasculitis or autoimmune condition was identified in either patient. To our knowledge, the association of necrotizing scleritis after intraocular surgery and polyester fiber suture material (Mersilene) has not been described.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
5/11. Necrotizing scleritis of scleral flaps after transscleral suture fixation of an intraocular lens.A 56-year-old woman with rheumatoid arthritis underwent intracapsular cataract extraction and sulcus fixation of an intraocular lens using transscleral fixation sutures buried under partial-thickness scleral flaps. Necrotizing scleritis confined to the area of the scleral flaps developed one month postoperatively, resulting in exposure and loosening of one fixation suture and lens implant decentration. The scleritis responded to systemic prednisone and cyclophosphamide treatment, with healing in two weeks. The final visual acuity was 20/30. Surgical trauma may stimulate local intravascular immune complex deposition and initiate the inflammatory process, thereby leading to necrotizing scleritis. This process should be considered when contemplating the use of scleral flaps in patients with collagen vascular disease and systemic vasculitis.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
6/11. Subpalpebral lavage antibiotic treatment for severe infectious scleritis and keratitis.OBJECTIVE: To report the subpalpebral lavage therapy for the treatment of infectious scleritis and keratitis. METHOD: Six patients were admitted for treatment of severe infectious scleritis and keratitis and were initiated on the subpalpebral lavage system after showing no improvement with topical fortified antibiotics. A continuous antibiotic lavage was applied until clinical sterility was achieved and topical steroids were gradually added to control concomitant inflammation. RESULTS: All 6 patients had resolution of their infections and achieved a stable ocular surface with no inflammation. One patient required a corneal transplant for active inflammation and corneal thinning, 1 had a transplant for a dense central corneal scar, and 1 patient underwent corneal transplant and cataract extraction. One case was a pseudomonas keratitis in a blind eye, which rapidly resolved and has remained stable. Four patients required additional surgeries, which included 3 corneal transplants, 2 cataract extractions, and 1 glaucoma aqueous shunt. CONCLUSION: Continuous irrigation of the eye can improve scleral penetration of antibiotics. Subpalpebral lavage provides continuous irrigation and may be effective in the treatment of infectious scleritis of a variety of etiologies.- - - - - - - - - - ranking = 2keywords = extraction (Clic here for more details about this article) |
7/11. Necrotising anterior scleritis after pterygium surgery.Necrotising anterior scleritis is a rare sequela of ocular surgery. Typically an intense scleral inflammation develops at or adjacent to the site of the previous surgery. necrosis supervenes and may then progress circumferentially to involve much of the anterior sclera. Surgically induced necrotising scleritis (SINS) has been previously described after cataract extraction, trabeculectomy, retinal detachment and strabismus surgery. We report three cases of SINS following pterygium excision. In each case the disease was prolonged, progressive and required protracted immunosuppressive therapy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/11. Necrotizing scleritis and transient myopia following strabismus surgery.Necrotizing scleritis may occur following ocular surgery, most commonly after cataract extraction. This complication developed in a 60-year-old woman following strabismus surgery for a gaze palsy and sixth-nerve paresis following a stroke. Although an autoimmune process is present in many patients with necrotizing scleritis, none was detected in this patient. inflammation was controlled with topical and systemic corticosteroids and ibuprofen. Good visual acuity was preserved, and improved ocular alignment was achieved. Transient myopia, not previously reported in necrotizing scleritis, was observed.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/11. Uveoscleritis after excessive neodymium:YAG laser posterior capsulotomy.A 66-year-old woman developed severe and recurrent scleritis and uveitis after neodymium:YAG capsulotomy performed 18 months after cataract extraction. Four cracks on the intraocular lens and plastic splinters in the vitreous indicated that excessive laser energy had been used. inflammation was treated successfully only when a combination of dexamethasone acetate 0.1% drops (Maxidex), drops of diclofenac sodium 0.1% (Voltaren Ophtha), and systemic diclofenac sodium (Voltaren) was used. inflammation might be explained by chronic irritation of the ciliary body by a displaced haptic or by an immune reaction triggered by damage to the ciliary body at the time of excessive posterior capsulotomy.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
10/11. Postoperative rhizopus scleritis in a diabetic man.A 50-year-old diabetic man developed necrotizing scleritis with adjacent keratitis 4 weeks after uncomplicated cataract extraction and intraocular lens implantation through a scleral tunnel incision. Cultures of the necrotic sclera grew Rizopus species. Severe destruction of the globe ensued despite topical, subconjunctival, and intravenous amphotericin b, in combination with hyperbaric oxygen therapy. Histopathological examination of the enucleated globe was consistent with rhizopus infection. One year later, the patient was well without signs of recurrence.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
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