Partial thickness scleral micro-patch graft, autoconjunctival graft and fibrin glue in management of surgically induced necrotizing scleritis

A 45-year-old male patient presented with necrotizing scleritis after 2 weeks of having undergone ptyregium surgery with bare sclera technique. Examination revealed a scleral thinning measuring 3 x 3 mm with anterior chamber inflammation. Lamellar scleral graft was dissected from the donor sclera and trephined to the approximate size of the scleral melt. Edges of the host scleral melt were freshened and fibrin tissue glue was used to attach the lamellar graft at the site of defect. Conjunctival autograft was simultaneously harvested from superior quadrant and attached over the bare sclera with the help of fibrin glue. Postoperatively the patient was prescribed high dose oral steroids along with topical antibiotics, steroids and lubricants. The patient improved symptomatically and showed good graft apposition.