Management of Surgically-Induced Necrotizing Scleritis: Case Series and Review of the Literature

Purpose of ReviewCurrently, surgically-induced necrotizing scleritis (SINS) is a pathology that does not have a specific treatment approach. Different techniques have been described in the literature, many with limited success. Our study is aimed at describing our surgical approach and clinical outcomes for management of SINS in contrast to other techniques described in the literature.Recent FindingsTenon-conjunctiva flaps are an excellent approach for SINS as it re-vascularizes the area of ischemia and halts necrosis. Other tissues such as corneal and scleral patch grafts, amniotic membrane, and collagen matrix have been described as feasible alternatives.SummarySINS is a complication of ocular surgery that should be identified promptly to avoid visually threatening consequences. Other causes of scleral necrosis, such as infection or autoimmunity, should be excluded first. The main goal for surgical management should include covering the necrotic area with a vascular pedicle flap that will feed the ischemic sclera and stop progression. Other types of tissues while useful to cover the defect oftentimes present with further melting.