Skip to main content
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1992 Jan;76(1):17–21. doi: 10.1136/bjo.76.1.17

Surgically induced necrotising sclerokeratitis (SINS)--precipitating factors and response to treatment.

E O'Donoghue 1, S Lightman 1, S Tuft 1, P Watson 1
PMCID: PMC504142  PMID: 1739684

Abstract

The clinical features, treatment, and visual outcome of 52 eyes from 43 patients who developed scleritis following surgery were reviewed. In all patients the scleral inflammation developed adjacent to a surgical wound. Ninety six per cent had necrotising disease and 23% also had evidence of secondary posterior scleritis. Many different types of ocular surgery were implicated and the majority (75%) of the patients had two or more surgical procedures before the onset of the scleritis. Although cataract extraction through a limbal incision resulted in the largest subgroup, scleritis also followed glaucoma, strabismus, and retinal detachment surgery. The latent period between surgery and the appearance of inflammation was short (mean 9 months) except for a small group in whom scleritis occurred many years after squint surgery. Sixty three per cent of patients had evidence of a systemic disease. Early diagnosis and aggressive medical treatment significantly improved the visual outcome. The precipitating factors, pathogenesis, and course of this condition are discussed.

Full text

PDF
21

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. APT L., COSTENBADER F. D., PARKS M. M., ALBERT D. G. Catgut allergy in eye muscle surgery. II. Correlation and comparison of eye reaction and skin test after the use of plain and chromicized catgut. Arch Ophthalmol. 1961 Apr;65:474–480. doi: 10.1001/archopht.1961.01840020476002. [DOI] [PubMed] [Google Scholar]
  2. Arentsen J. J., Christiansen J. M., Maumenee A. E. Marginal ulceration after intracapsular cataract extraction. Am J Ophthalmol. 1976 Feb;81(2):194–197. doi: 10.1016/0002-9394(76)90730-3. [DOI] [PubMed] [Google Scholar]
  3. Benson W. E. Posterior scleritis. Surv Ophthalmol. 1988 Mar-Apr;32(5):297–316. doi: 10.1016/0039-6257(88)90093-8. [DOI] [PubMed] [Google Scholar]
  4. Bloomfield S. E., Becker C. G., Christian C. L., Nauheim J. S. Bilateral necrotising scleritis with marginal corneal ulceration after cataract surgery in a patient with vasculitis. Br J Ophthalmol. 1980 Mar;64(3):170–174. doi: 10.1136/bjo.64.3.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Calthorpe C. M., Watson P. G., McCartney A. C. Posterior scleritis: a clinical and histological survey. Eye (Lond) 1988;2(Pt 3):267–277. doi: 10.1038/eye.1988.52. [DOI] [PubMed] [Google Scholar]
  6. Ebringer R., Cawdell D., Ebringer A. Klebsiella pneumoniae and acute anterior uveitis in ankylosing spondylitis. Br Med J. 1979 Feb 10;1(6160):383–383. doi: 10.1136/bmj.1.6160.383. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Grindle C. F., Marshall J., McLeod D., Clarke E., Fison L. G. Complications of explants used in retinal detachment surgery. Mod Probl Ophthalmol. 1979;20:219–222. [PubMed] [Google Scholar]
  8. Hembry R. M., Playfair J., Watson P. G., Dingle J. T. Experimental model for scleritis. Arch Ophthalmol. 1979 Jul;97(7):1337–1340. doi: 10.1001/archopht.1979.01020020079019. [DOI] [PubMed] [Google Scholar]
  9. Lyne A. J., Lloyd-Jones D. Necrotizing scleritis after ocular surgery. Trans Ophthalmol Soc U K. 1979 Apr;99(1):146–149. [PubMed] [Google Scholar]
  10. Salamon S. M., Mondino B. J., Zaidman G. W. Peripheral corneal ulcers, conjunctival ulcers, and scleritis after cataract surgery. Am J Ophthalmol. 1982 Mar;93(3):334–337. doi: 10.1016/0002-9394(82)90535-9. [DOI] [PubMed] [Google Scholar]
  11. Singh V. K., Yamaki K., Donoso L. A., Shinohara T. Sequence homology between yeast histone H3 and uveitopathogenic site of S-antigen: lymphocyte cross-reaction and adoptive transfer of the disease. Cell Immunol. 1989 Mar;119(1):211–221. doi: 10.1016/0008-8749(89)90237-2. [DOI] [PubMed] [Google Scholar]
  12. Watson P. G. Doyne Memorial Lecture, 1982. The nature and the treatment of scleral inflammation. Trans Ophthalmol Soc U K. 1982 Jul;102(Pt 2):257–281. [PubMed] [Google Scholar]
  13. Watson P. G., Hayreh S. S. Scleritis and episcleritis. Br J Ophthalmol. 1976 Mar;60(3):163–191. doi: 10.1136/bjo.60.3.163. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES