Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report

Chidi Ihemedu; Oluwaseun Awe; Ogbonne Nwankwo

doi:doi:10.11648/j.ijovs.20180302.11

| Peer-Reviewed

Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report

Chidi Ihemedu, Oluwaseun Awe, Ogbonne Nwankwo

Published in International Journal of Ophthalmology & Visual Science (Volume 3, Issue 2)

Received: 20 May 2018 Accepted: 19 June 2018 Published: 17 July 2018

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.

Published in	International Journal of Ophthalmology & Visual Science (Volume 3, Issue 2)
DOI	10.11648/j.ijovs.20180302.11
Page(s)	17-20
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Corneal Dellen, Scleral Dellen, Scleral Thinning, Bilateral Pterygia, Nigerian Adult

References

[1]	Sehu KW, Lee WR. Ophthalmic pathology: an illustrated guide for clinicians. John Wiley & Sons, 2012.
[2]	Hirst LW. The Treatment Of Pterygium. Surv Ophthalmol 2003; 48: 145–180.
[3]	Ang LPK, Chua JLL, Tan DTH. Current concepts and techniques in pterygium treatment. Curr Opin Ophthalmol 2007; 18: 308–313.
[4]	Chen S, Noonan C. Scleral dellen complicating primary pterygium excision. Eye 2000; 14: 100–101.
[5]	Accorinti M, Gilardi M, Giubilei M. Corneal and Scleral Dellen after an Uneventful Pterygium Surgery and a Febrile Episode. 2014; 111–115.
[6]	Walkow T, Daniel J, Meyer CH, et al. Long-Term Results After Bare Sclera Pterygium Resection With Excimer Smoothing and Local Application of Mitomycin C. 2005; 24: 378–381.
[7]	Tsai Y, Lin J, Shy J. Acute Scleral Thinning After Pterygium Excision with Intraoperative Mitomycin C A Case Report of Scleral Dellen After Bare Sclera Technique and Review of the Literature. 2002; 21: 227–229.
[8]	Kymionis GD, Plaka A, Kontadakis GA, et al. Treatment of corneal dellen with a large diameter soft contact lens. Contact Lens Anterior Eye 2011; 34: 290–292.
[9]	Garcia-Medina JJ, Del-Rio-Vellosillo M, Zanon-Moreno V, et al. Severe scleral dellen as an early complication of pterygium excision with simple conjunctival closure and review of the literature. Arq Bras Oftalmol 2014; 77: 182–184.
[10]	Li M, Zhang M, Lin Y, et al. Tear function and goblet cell density after pterygium excision. Eye 2007; 21: 224–228.
[11]	Sridhar MS, Bansal AK, Rao GN. Multilayered amniotic membrane transplantation for partial thickness scleral thinning following pterygium surgery. Eye 2002; 16: 639–642.
[12]	Safianik B, Ben-Zion I, Garzozi HJ. Serious corneoscleral complications after pterygium excision with mitomycin C. Br J Ophthalmol 2002; 86: 357–358.
[13]	Hicks RR, Irvine AR, Spencer WH, et al. Scleral dellen. Arch Ophthalmol 1975; 93: 88–89.
[14]	Saifuddin S, Zawawi A. Scleral changes due to mitomycin C after Pterygium excision: A report of two cases. Indian J Ophthalmol 1995; 43: 75–76.
[15]	Norliza WMW, Raihan IS, Azwa JA, et al. Scleral melting 16 years after pterygium excision with topical Mitomycin C adjuvant therapy. Contact Lens Anterior Eye 2006; 29: 165–167.

Cite This Article

Plain Text BibTeX RIS

APA Style

Chidi Ihemedu, Oluwaseun Awe, Ogbonne Nwankwo. (2018). Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report. International Journal of Ophthalmology & Visual Science, 3(2), 17-20. https://doi.org/10.11648/j.ijovs.20180302.11

Copy | Download

ACS Style

Chidi Ihemedu; Oluwaseun Awe; Ogbonne Nwankwo. Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report. Int. J. Ophthalmol. Vis. Sci. 2018, 3(2), 17-20. doi: 10.11648/j.ijovs.20180302.11

Copy | Download

AMA Style

Chidi Ihemedu, Oluwaseun Awe, Ogbonne Nwankwo. Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report. Int J Ophthalmol Vis Sci. 2018;3(2):17-20. doi: 10.11648/j.ijovs.20180302.11

Copy | Download

@article{10.11648/j.ijovs.20180302.11,
  author = {Chidi Ihemedu and Oluwaseun Awe and Ogbonne Nwankwo},
  title = {Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {3},
  number = {2},
  pages = {17-20},
  doi = {10.11648/j.ijovs.20180302.11},
  url = {https://doi.org/10.11648/j.ijovs.20180302.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20180302.11},
  abstract = {We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report
AU  - Chidi Ihemedu
AU  - Oluwaseun Awe
AU  - Ogbonne Nwankwo
Y1  - 2018/07/17
PY  - 2018
N1  - https://doi.org/10.11648/j.ijovs.20180302.11
DO  - 10.11648/j.ijovs.20180302.11
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 17
EP  - 20
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20180302.11
AB  - We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.
VL  - 3
IS  - 2
ER  -

Copy | Download

Author Information

Chidi Ihemedu

Department of Ophthalmology, Lily Hospitals Limited, Warri, Nigeria
Oluwaseun Awe

Department of Ophthalmology, Obafemi Awolowo University, Ile-Ife, Nigeria
Ogbonne Nwankwo

Department of Ophthalmology, Lily Hospitals Limited, Warri, Nigeria

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Chidi Ihemedu, Oluwaseun Awe, Ogbonne Nwankwo. (2018). Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report. International Journal of Ophthalmology & Visual Science, 3(2), 17-20. https://doi.org/10.11648/j.ijovs.20180302.11

Copy | Download

ACS Style

Chidi Ihemedu; Oluwaseun Awe; Ogbonne Nwankwo. Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report. Int. J. Ophthalmol. Vis. Sci. 2018, 3(2), 17-20. doi: 10.11648/j.ijovs.20180302.11

Copy | Download

AMA Style

Chidi Ihemedu, Oluwaseun Awe, Ogbonne Nwankwo. Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report. Int J Ophthalmol Vis Sci. 2018;3(2):17-20. doi: 10.11648/j.ijovs.20180302.11

Copy | Download

@article{10.11648/j.ijovs.20180302.11,
  author = {Chidi Ihemedu and Oluwaseun Awe and Ogbonne Nwankwo},
  title = {Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {3},
  number = {2},
  pages = {17-20},
  doi = {10.11648/j.ijovs.20180302.11},
  url = {https://doi.org/10.11648/j.ijovs.20180302.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20180302.11},
  abstract = {We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.},
 year = {2018}
}

Copy | Download

TY  - JOUR
T1  - Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report
AU  - Chidi Ihemedu
AU  - Oluwaseun Awe
AU  - Ogbonne Nwankwo
Y1  - 2018/07/17
PY  - 2018
N1  - https://doi.org/10.11648/j.ijovs.20180302.11
DO  - 10.11648/j.ijovs.20180302.11
T2  - International Journal of Ophthalmology & Visual Science
JF  - International Journal of Ophthalmology & Visual Science
JO  - International Journal of Ophthalmology & Visual Science
SP  - 17
EP  - 20
PB  - Science Publishing Group
SN  - 2637-3858
UR  - https://doi.org/10.11648/j.ijovs.20180302.11
AB  - We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.
VL  - 3
IS  - 2
ER  -

Copy | Download