CASE REPORTS: Delayed presentation of surgically induced scleral necrosis after I-BRITE procedure treated with immunosuppressive therapy

Surgically induced scleral necrosis (SISN) is an uncommon complication of ocular procedures. Cosmetic eye-whitening surgery involves conjunctival and Tenon’s capsule dissection, cautery, and mitomycin C application. We report the case of a 36-year-old white woman referred to our clinic for severe pa...

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Published inDigital journal of ophthalmology
Main Authors Azar, Nadim S., Ruiz-Lozano, Raul E., Quiroga-Garza, Manuel E., Soifer, Matias, Mousa, Hazem M., Komai, Seitaro, Leverenz, David L., Perez, Victor L.
Format Journal Article
LanguageEnglish
Published 11.09.2023
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Summary:Surgically induced scleral necrosis (SISN) is an uncommon complication of ocular procedures. Cosmetic eye-whitening surgery involves conjunctival and Tenon’s capsule dissection, cautery, and mitomycin C application. We report the case of a 36-year-old white woman referred to our clinic for severe pain, scleral inflammation, and necrosis in both eyes 9 years after I-BRITE, an elective eye-whitening procedure. An extensive workup yielded negative results. The patient improved with aggressive lubrication and topical and high-dose systemic prednisone (60 mg), with recurrence upon steroid tapering. Concomitant weekly methotrexate was added, resulting in inflammatory control and allowing discontinuance of topical and oral steroids.
ISSN:1542-8958
1542-8958
DOI:10.5693/djo.02.2023.04.005