The clinical and pathogenic spectrum of surgically-induced scleral necrosis: A review
| Autor: | C. Stephen Foster, Raul E. Ruiz-Lozano, Lucas A Garza-Garza, Osvaldo Davila-Cavazos, Alejandro Rodríguez-García |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty Necrosis genetic structures Ocular surgery Ischemia Pterygium Transplantation Autologous 03 medical and health sciences 0302 clinical medicine Immune system medicine Humans Surgical repair Autoimmune disease Delayed wound healing business.industry medicine.disease eye diseases Sclera Ophthalmology medicine.anatomical_structure 030221 ophthalmology & optometry sense organs medicine.symptom business 030217 neurology & neurosurgery Scleritis |
| Zdroj: | Survey of Ophthalmology. 66:594-611 |
| ISSN: | 0039-6257 |
| Popis: | The onset of scleral necrosis after ocular surgery may have catastrophic ocular and systemic consequences. The two most frequent surgeries causing surgically-induced scleral necrosis (SISN) are pterygium excision and cataract extraction. Several pathogenic mechanisms are involved in surgically induced scleral necrosis. All of them are poorly understood. Ocular trauma increasing lytic action of collagenases with subsequent collagen degradation, vascular disruption leading to local ischemia, and immune complex deposition activating the complement system represents some of the events that lead to scleral necrosis. The complex cascade of events involving different pathogenic mechanisms and the patient's abnormal immune response frequently leads to delayed wound healing that predisposes the development of scleral necrosis. The management of SISN ranges from short-term systemic anti-inflammatory drugs to aggressive immunosuppressive therapy and surgical repair. Therefore, before performing any ocular surgery involving the sclera, a thorough ophthalmic and systemic evaluation must be done to identify high-risk patients that may develop SISN. |
| Databáze: | OpenAIRE |
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