Successful treatment of surgically induced necrotizing scleritis with tacrolimus

A 46‐year‐old man developed surgically induced necrotizing scleritis (SINS) 7 months following uneventful primary bare sclera pterygium excision. The patient underwent two scleral patch grafts for SINS but despite the use of cyclophosphamide and azathioprine, the scleral patch grafts failed within 1 month of surgery on both occasions. Tacrolimus was used for his third scleral patch graft. No recurrence of necrotizing scleritis was observed for 2 years. Tacrolimus may be considered as a valuable adjunctive immunosuppressant in the management of resistant necrotizing scleritis.

[1]  J. Y. Ku,et al.  Keratoglobus and posterior subcapsular cataract: surgical considerations and in vivo microstructural analysis. , 2004, Journal of cataract and refractive surgery.

[2]  R. Pandey,et al.  In-vivo slit scanning confocal microscopy of normal corneas in Indian eyes. , 2003, Indian journal of ophthalmology.

[3]  R. Ambrósio,et al.  Morphology of Corneal Basal Epithelial Cells by In Vivo Slit-Scanning Confocal Microscopy , 2003, Cornea.

[4]  Graeme J. Williams,et al.  Supraventricular ectopics and supraventricular tachycardia following injection of subconjunctival Mydricaine No. 2 , 2001, Eye.

[5]  D. Steel,et al.  The incidence of systemic side-effects following subconjunctival Mydricaine No. 1 injection , 1999, Eye.

[6]  H. Dua,et al.  Tacrolimus (FK506) in the treatment of posterior uveitis refractory to cyclosporine. , 1999, Ophthalmology.

[7]  D. Cottrell,et al.  Haemodynamic responses to subconjunctival mydriatic agents (Mydricaine) used for maintenance of perioperative mydriasis in patients undergoing vitreoretinal surgery , 1998, Eye.

[8]  D. Cottrell,et al.  Persistent tachycardia following subconjunctival injections of mydriatic agents (Mydricaine) used for maintenance of perioperative mydriasis in vitreoretinal surgery , 1995, Eye.

[9]  S. Ohno,et al.  FK506 treatment of noninfectious uveitis. , 1994, American journal of ophthalmology.

[10]  G. Snibson,et al.  Necrotising anterior scleritis after pterygium surgery. , 1994, Australian and New Zealand journal of ophthalmology.

[11]  F. Meire,et al.  Megalocornea , 2005, Documenta Ophthalmologica.

[12]  J. Pandit Tachycardia and myocardial ischaemia following subconjunctival injection of Mydricaine No. 2 , 1994, Eye.

[13]  S. Tuft,et al.  Surgically induced necrotising sclerokeratitis (SINS)--precipitating factors and response to treatment. , 1992, The British journal of ophthalmology.

[14]  C. Foster,et al.  Scleral Grafting for Necrotizinf Scleritis , 1989 .

[15]  C. Foster,et al.  Scleral grafting for necrotizing scleritis. , 1989, Ophthalmology.

[16]  W. Rotkis,et al.  Diagnosis of anterior chamber metastasis by serologic marker found during anterior chamber paracentesis. , 1986, American journal of ophthalmology.

[17]  D. Albert,et al.  Experimental anterior uveitis after subcutaneous injection of feline sarcoma virus. , 1983, Investigative ophthalmology & visual science.

[18]  J. Sugar,et al.  Corneal endothelial cell measurements in megalocornea. , 1983, Archives of ophthalmology.

[19]  P. Beighton,et al.  Clinical and Genetic Aspects , 1980 .

[20]  A. Young Megalocornea and mosaic dystrophy in identical twins. , 1968, American journal of ophthalmology.

[21]  E. Malbrán,et al.  MEGALOCORNEA AND MOSAIC DYSTROPHY OF THE CORNEA. , 1964, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde.

[22]  S. Uyama [CONGENITAL ANOMALIES OF THE CORNEA]. , 1964, Nihon ganka kiyo.

[23]  B. B. Carenini JUVENILE FAMILIAL MOSAIC DEGENERATION OF THE CORNEA ASSOCIATED WITH MEGALOCORNEA* , 1961, The British journal of ophthalmology.