Successful treatment of surgically induced necrotizing sclerokeratitis (SINS) with systemic immunosuppresive agents and amniotic membrane grafting

• Published in: Archivos de la Sociedad Española de Oftalmología Vol. 84; no. 11; pp. 577 - 580
• Main Authors: Cordero-Coma, M, Franco-Benito, M, García-Ruiz-de-Morales, J M, Alonso-Orcajo, N, Del Barrio-Manso, I
• Format: Journal Article
• Language: Spanish
• Published: Spain 01-11-2009
• Subjects: Aged; Amnion - transplantation; Combined Modality Therapy; Female; Humans; Immunosuppressive Agents - therapeutic use; Keratitis - etiology; Keratitis - pathology; Keratitis - therapy; Necrosis; Postoperative Complications - etiology; Postoperative Complications - therapy; Remission Induction; Scleral Diseases - etiology; Scleral Diseases - pathology; Scleral Diseases - therapy
• ISSN: 1989-7286

We report the case of a 74-year-old female who developed a necrotizing sclerokeratitis affecting her left eye after uncomplicated cataract surgery. She had no previous history of systemic autoimmune disease. Histopathology of the lesion revealed necrotic granulomatosis with an increased number of plasma cells.
Surgically induced necrotizing sclerokeratitis (SINS) is a serious entity which requires prompt and aggressive therapy to prevent its potential devastating ocular consequences. Conjunctival resection and amniotic membrane grafting may be necessary to temporarily interrupt local immunologic events in severe cases. However, associated systemic immunomodulatory therapy seems to be mandatory (Arch Soc Esp Oftalmol 2009; 84: 577-580).