Abstract

A case report of a 52-year-old Bahraini male who underwent pterygium surgery with amniotic membrane transplant without adjunctive therapy of mitomycin C or beta irradiation. Post operatively, he developed necrotizing scleritis at the site of pterygium surgery. He underwent conjunctival graft on the scleritis. One week post operatively, the conjunctival graft melted and the scleritis persisted. Subsequently, he had scleral patch graft on the scleral defect overlayed by a conjunctival autograft. His post-operative course was uneventful. This case shows that scleral melt can happen post pterygium surgery with amniotic membrane transplant. This complication is well documented following the use of adjunctive therapy such as mitomycin C or beta irradiation. It has also been reported following pterygium surgery with the bare scleral technique. To our knowledge this is the first reported case of necrotizing scleritis without adjunctive treatment and with amniotic membrane transplant. Ophthalmic surgeons should take this complication into consideration before any pterygium surgery.

Keywords: pterygium, necrotizing scleritis, scleral melt, scleral graft