Background
To report the case of a surgical-induced necrotizing sclertitis (SINS) following vitreoretinal retinal surgery for rhegmatogenous retinal detachment, successfully managed by superficial muscle temporal fascia grafting.
Case presentation
An 18-year-old teenage, with a history of a twenty-three gauges vitrectomy with silicone oil tamponade forrhegmatogenous retinal detachment of the left eye presented two months after surgery with intense left ocular pain, decreased visual acuity to counting fingers and eye redness. Split lamp exam showed: conjunctival infiltration with silicone oil, circumferential sclera thinningpredominantly in the superonasal quadrant with ectasia of the underling uvea). The fundus examination showed an attached retina.
Necrotizing scleritis was the retained diagnosis. Performed etiological assessment was negative.Surgical induced necrotizing scleritis was the final diagnosis. An immunosuppressive therapy based on general corticoids was started. With the immanent risk of globe perforation, superficial muscle temporal fascia grafting was performed to cover the necrotizing sclera.The patient did well postoperatively without sclera thinning or ectasia and the fascia grafting still intact without retraction after six months of follow up.
Conclusion
This is the first case in the literature thatused the superficial temporal muscle fascia as a graft for sclera reinforcement in SINS. Wepropose a new support to reinforce the deficient sclera.This graft must be associated with prompt immunosuppressive therapy at high doses.