Autologous Serum Treatment for Corneoscleral Dellen Following Pterygium Surgery

Abstract

Biz bu vakada problemsiz limbal konjonktival otogreftli pterjium cerrahisi sonrası gelişen korneaskleral dellen için otolog serum tedavisini sunuyoruz. Sol gözünde kızarıklık ve batma semptomları olan 52 yaşında erkek hastaya nazal primer pterjium tanısı konuldu. Sol nazal pterjium eksizyonu ve konjonktival otogreft implantasyonu yardımcı antimetabolit ilaç kullanılmadan gerçekleştirildi. Greft topikal stereoid, antibiyotik ve suni gözyaşına rağmen postoperatif 11. gün nekrotik ve erimişti. Burada korneaskleral dellen mevcuttu. Topikal stereoid uygulaması sonlandırıldı ve suni göz yaşı sıklığı arttırıldı (24x1). Korneaskleral dellen, lubrikant jel ilavesine rağmen postoperatif 15. gün gerilemedi. Tedaviye %30 konsantrasyonda otolog serum damla eklendi. Postoperatif 22. gün korneal dellen tamamen iyileşti ve skleral kalınlaşma gözlendi. Sonuç olarak, otolog serum geleneksel tedaviye dirençli geniş korneaskleral dellen geliştiği zaman tedavi seçenekleri arasında düşünülebilir.

In this case report we present autologous serum treatment for corneoscleral dellen developing after an uneventful pterygium surgery with limbal conjunctival autograft. A 52-year-old male patient presenting with symptoms of stinging and redness in the left eye was diagnosed with nasal primary pterygium. Left nasal pterygium excision and conjunctival autograft implantation were performed without an adjunctive antimetabolite therapy. The graft was necrotic and liquefied on the postoperative 11th day despite topical steroid, antibiotic, and artificial tear administration. There was corneoscleral dellen. Upon which topical steroid application was stopped and the frequency of artificial tear administration was increased (24x1). Corneoscleral dellen did not regress on the postoperative 15th day the despite addition of lubricant gels/ointment to the treatment. Subsequently autologous serum drops at a concentration of 30% were also added to the treatment. Corneal dellen was completely healed and scleral re-surfacing was observed on the postoperative 22nd day. In conclusion, we believe that autologous serum administration should be considered among the treatment options when wide corneoscleral dellen formations, which are resistant to conventional treatments, are seen in patients.