CASE REPORTS: Delayed presentation of surgically induced scleral necrosis after I-BRITE procedure treated with immunosuppressive therapy

Author:

Azar Nadim S.,Ruiz-Lozano Raul E.ORCID,Quiroga-Garza Manuel E.ORCID,Soifer MatiasORCID,Mousa Hazem M.,Komai Seitaro,Leverenz David L.ORCID,Perez Victor L.

Abstract

Surgically induced scleral necrosis (SISN) is an uncommon complication of ocular procedures. Cosmetic eye-whitening surgery involves conjunctival and Tenon’s capsule dissection, cautery, and mitomycin C application. We report the case of a 36-year-old white woman referred to our clinic for severe pain, scleral inflammation, and necrosis in both eyes 9 years after I-BRITE, an elective eye-whitening procedure. An extensive workup yielded negative results. The patient improved with aggressive lubrication and topical and high-dose systemic prednisone (60 mg), with recurrence upon steroid tapering. Concomitant weekly methotrexate was added, resulting in inflammatory control and allowing discontinuance of topical and oral steroids.

Publisher

Digital Journal of Opthalmology

Subject

General Medicine

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