Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Surgically Induced Scleral Necrosis in a Patient With Rheumatoid Arthritis After AGV Implantation

Kumar, Suresh MS; Ichhpujani, Parul MS; Thakur, Sahil MBBS

doi: 10.1097/IJG.0000000000000860
Online Articles: Case Report/Small Case Series

Introduction: Surgically induced scleral necrosis (SINS) is a rare entity that has till date not been reported in a patient of glaucoma undergoing Ahmed glaucoma valve (AGV) implantation.

Methods: We present a case of primary open-angle glaucoma who underwent AGV implantation followed by development of scleral necrosis, involving both the scleral patch graft and host sclera. After failure of surgical and medical management, AGV had to be explanted. The patient was diagnosed with rheumatoid arthritis and had to be treated with steroids and azathioprine for the same.

Results: SINS is a potentially disastrous complication of ocular surgery that can occur in patients with systemic diseases like rheumatoid arthritis and requires aggressive management to salvage the eye.

Conclusion: SINS can occur with AGV implantation. Treatment may require aggressive medical and surgical intervention. It is imperative to evaluate patients for systemic illness before planning an AGV implant.

Department of Ophthalmology, Government Medical College and Hospital, Chandigarh, India

Disclosure: The authors declare no conflict of interest.

Reprints: Parul Ichhpujani, MS, Department of Ophthalmology, Government Medical College and Hospital, Sector-32, Chandigarh, 160031, India (e-mail:

Received August 23, 2017

Accepted December 12, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.