{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T15:46:45Z","timestamp":1772639205959,"version":"3.50.1"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T00:00:00Z","timestamp":1654041600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,5,15]],"date-time":"2022-05-15T00:00:00Z","timestamp":1652572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>We describe the management of a scleral thinning after uneventful pterygium surgery, it is an uncommon complication; in addition, we have reviewed similar published cases in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A 48-year-old woman presented with thinning sclera in the first week after pterygium excision surgery. Conservative treatment was the first line in the management. There was no improvement for two weeks, so we decided to do a rotational flap. We put a scleral dellen diagnosis by excluding other etiologies. The condition was successfully managed, the thinning sclera healed completely. Scleral and conjunctival re-surfacing was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>Scleral dellen is an early and rare postoperative complication after pterygium surgery. The diagnosis is confirmed after excluding other causes of scleral thinning. The exact pathophysiology of it is not determined yet, many authors described probable explanation in their published cases. We did a comprehensive review of similar cases with their management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Scleral dellen is uncommon complication after pterygium surgery, its diagnosis depends on exclusion. The management can be conservative. However, if no progression was detected do not hesitate going for surgical closure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.107223","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T02:51:49Z","timestamp":1652842309000},"page":"107223","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A case of resistant scleral thinning following uneventful pterygium surgery"],"prefix":"10.1097","volume":"95","author":[{"given":"Dana","family":"Sultan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Othman","family":"Alnema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad Nour","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadim","family":"Zahlouk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ammar","family":"Kayyali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-73-20260304","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.ophtha.2012.06.066","article-title":"Options and adjuvants in surgery for pterygium: a report by the American Academy of Ophthalmology","volume":"120","author":"Kaufman","year":"2013","journal-title":"Ophthalmology"},{"key":"R2-73-20260304","doi-asserted-by":"crossref","first-page":"197","DOI":"10.4103\/1596-3519.84695","article-title":"Treatment of pterygium","volume":"10","author":"Mohammed","year":"2011","journal-title":"Ann. Afr. Med"},{"key":"R3-73-20260304","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R4-73-20260304","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1136\/bjo.77.11.698","article-title":"Pterygium excision with conjunctival autografting: an effective and safe technique","volume":"77","author":"Allan","year":"1993","journal-title":"Br. J. Ophthalmol"},{"key":"R5-73-20260304","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1097\/00003226-200203000-00022","article-title":"Acute scleral thinning after pterygium excision with intraoperative mitomycin C: a case report of scleral dellen after bare sclera technique and review of the literature","volume":"21","author":"Tsai","year":"2002","journal-title":"Cornea"},{"key":"R6-73-20260304","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1038\/eye.2000.22","article-title":"Scleral dellen complicating primary pterygium excision","volume":"14","author":"Chen","year":"2000","journal-title":"Eye"},{"key":"R7-73-20260304","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/00003226-199105000-00002","article-title":"Conjunctival autograft for primary and recurrent pterygia: surgical technique and problem management","volume":"10","author":"Starck","year":"1991","journal-title":"Cornea"},{"key":"R8-73-20260304","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1159\/000362156","article-title":"Corneal and scleral dellen after an uneventful pterygium surgery and a febrile episode","volume":"5","author":"Accorinti","year":"2014","journal-title":"Case Rep. Ophthalmol"},{"key":"R9-73-20260304","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1038\/eye.2000.263","article-title":"Scleral dellen complicating primary pterygium excision","volume":"14","author":"Mitra","year":"2000","journal-title":"Eye"},{"key":"R11-73-20260304","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1001\/archopht.1975.01010020092020","article-title":"Scleral dellen","volume":"93","author":"Hicks","year":"1975","journal-title":"Arch. Ophthalmol"},{"key":"R12-73-20260304","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1136\/bjo.86.3.357","article-title":"Serious corneoscleral complications after pterygium excision with mitomycin c","volume":"86","author":"<collab>B S","year":"2002","journal-title":"Br. J. Ophthalmol"},{"key":"R13-73-20260304","doi-asserted-by":"crossref","first-page":"182","DOI":"10.5935\/0004-2749.20140046","article-title":"Severe scleral dellen as an early complication of pterygium excision with simple conjunctival closure and review of the literature","volume":"77","author":"Garcia-Medina","year":"2014","journal-title":"Arq. Bras. Oftalmol"},{"key":"R16-73-20260304","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1038\/sj.eye.6700123","article-title":"Multilayered amniotic membrane transplantation for partial thickness scleral thinning following pterygium surgery [2]","volume":"16","author":"Sridhar","year":"2002","journal-title":"Eye"},{"key":"R17-73-20260304","doi-asserted-by":"crossref","first-page":"75","DOI":"10.4103\/kjo.kjo_45_20","article-title":"An unusual case of scleral thinning with uveal exposure following pterygium surgery and its management","volume":"33","author":"Chavhan","year":"2021","journal-title":"Kerala J. Ophthalmol"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222004692?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222004692?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.107223","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:04:10Z","timestamp":1772618650000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.107223"}},"subtitle":["A case report and a literature review"],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":14,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2022.107223","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}