The clinical and pathogenic spectrum of surgically-induced scleral necrosis: A review.
Surv Ophthalmol
; 66(4): 594-611, 2021.
Article
em En
| MEDLINE
| ID: mdl-33422510
The onset of scleral necrosis after ocular surgery may have catastrophic ocular and systemic consequences. The two most frequent surgeries causing surgically-induced scleral necrosis (SISN) are pterygium excision and cataract extraction. Several pathogenic mechanisms are involved in surgically induced scleral necrosis. All of them are poorly understood. Ocular trauma increasing lytic action of collagenases with subsequent collagen degradation, vascular disruption leading to local ischemia, and immune complex deposition activating the complement system represents some of the events that lead to scleral necrosis. The complex cascade of events involving different pathogenic mechanisms and the patient's abnormal immune response frequently leads to delayed wound healing that predisposes the development of scleral necrosis. The management of SISN ranges from short-term systemic anti-inflammatory drugs to aggressive immunosuppressive therapy and surgical repair. Therefore, before performing any ocular surgery involving the sclera, a thorough ophthalmic and systemic evaluation must be done to identify high-risk patients that may develop SISN.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pterígio
/
Esclerite
Tipo de estudo:
Etiology_studies
Limite:
Humans
Idioma:
En
Revista:
Surv Ophthalmol
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
México
País de publicação:
Estados Unidos