Necrotizing scleritis after intraocular surgery associated with the use of polyester nonabsorbable sutures. 2003

John Stokes, and Mark Wright, and Kanna Ramaesh, and Colin Smith, and Baljean Dhillon
Princess Alexandra Eye Pavilion, Edinburgh, Scotland, United Kingdom. jst2121@aol.com

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.

UI MeSH Term Description Entries
D009336 Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply.
D011093 Polyethylene Terephthalates Polyester polymers formed from terephthalic acid or its esters and ethylene glycol. They can be formed into tapes, films or pulled into fibers that are pressed into meshes or woven into fabrics. Dacron,Nalophan,PET Polymer,Poly(Ethylene Terephtalate),Polyethylene Terephthalate,Tedlar,Dacrons,Nalophans,PET Polymers,Tedlars,Terephthalate, Polyethylene,Terephthalates, Polyethylene
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013508 Ophthalmologic Surgical Procedures Surgery performed on the eye or any of its parts. Ophthalmologic Surgical Procedure,Ophthalmological Surgical Procedures,Procedure, Ophthalmologic Surgical,Procedures, Ophthalmologic Surgical,Surgical Procedure, Ophthalmologic,Surgical Procedures, Ophthalmologic,Ophthalmological Surgical Procedure,Procedure, Ophthalmological Surgical,Procedures, Ophthalmological Surgical,Surgical Procedure, Ophthalmological,Surgical Procedures, Ophthalmological
D013537 Sutures Materials used in closing a surgical or traumatic wound. (From Dorland, 28th ed) Staples, Surgical,Surgical Staples,Staple, Surgical,Surgical Staple,Suture
D015423 Scleritis Refers to any inflammation of the sclera including episcleritis, a benign condition affecting only the episclera, which is generally short-lived and easily treated. Classic scleritis, on the other hand, affects deeper tissue and is characterized by higher rates of visual acuity loss and even mortality, particularly in necrotizing form. Its characteristic symptom is severe and general head pain. Scleritis has also been associated with systemic collagen disease. Etiology is unknown but is thought to involve a local immune response. Treatment is difficult and includes administration of anti-inflammatory and immunosuppressive agents such as corticosteroids. Inflammation of the sclera may also be secondary to inflammation of adjacent tissues, such as the conjunctiva. Episcleritis,Necrotizing Scleritis,Episcleritides,Necrotizing Scleritides,Scleritides,Scleritides, Necrotizing,Scleritis, Necrotizing

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