Severe Corneoscleral Dellen Following Uneventful Bilateral Pterygia Excision in a Nigerian Adult: A Case Report

We describe a patient who had uneventful excision of bilateral nasal pterygia using bare sclera technique with adjunctive topical antimetabolite therapy and subsequently developed bilateral corneoscleral dellen. A 44-year old Nigerian male presented with signs of bilateral nasal pterygia and had surgery done on both eyes. The pterygia excisions were performed under local anaesthesia using bare sclera technique with intraoperative adjunctive antimetabolite application. There was no post-operative complication until after 23 days with the appearance of bilateral corneal and sclera dellen, first on the left eye then the right with 5 days interval between both eyes. Treatment modality involved topical lubricant therapy, alternating eye patching and bandage contact lens. Corneal and sclera epithelization occurred in both eyes after six weeks of medical therapy with a slightly inflamed recurrent pterygium in the right eye. Corneal and sclera dellen is a rare late complication of uneventful pterygium excision with adjunctive therapy and it can however be managed effectively by medical therapy albeit increased risk of early recurrence of the pterygium.