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Surgery & Complications
Scleral thinning in a patient with history of pterygium surgery and mitomycin-C application.

  • Topical antimetabolites such as mitomycin-C or triethylene thiophosphamide have been routinely used as an adjunctive therapy after pterygium removal surgery to decrease the likelihood of recurrency.
  • May be complicated with corneal or scleral thinning, ulceration and necrosis especially when bare scleral technique is applied.
  • Clinical features:
    • Symptoms: may be asymptomatic or associated with ocular irritation
    • Signs:
      • Scleral thinning with trans-sclerally visible choroid
      • Hyperemia of the overlying conjunctiva
      • May progress to scleral perforation
  • Management:
    • Observation, if asymptomatic and no evidence of perforation.
    • Surgical patch grafts to reinforce the thinning sclera.

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