{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T19:10:05Z","timestamp":1793214605494,"version":"4.5.0"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:00:00Z","timestamp":1738108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Scleritis, an inflammation of the sclera, can result from infections, autoimmune diseases, or systemic conditions like connective tissue disorders. Secondary glaucoma from scleritis is rare but challenging to manage. This report presents a case of iStent migration in a patient with refractory idiopathic scleritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report:<\/jats:title>\n                    <jats:p>A 56-year-old female with a history of diabetes mellitus, hypertension, and refractory scleritis, complicated by secondary glaucoma. Despite multiple interventions, including selective laser trabeculoplasty, deep sclerectomy, and phacoemulsification with toric intraocular lens (IOL) implantation. The patient required the insertion of an iStent in the left eye. Postoperatively, the iStent migrated into the subconjunctival space, leading to elevated intraocular pressure (IOP) and necessitating further management. Examination revealed severe scleral thinning and uveal prolapse, with significantly elevated IOP in the left eye. Medical management included systemic immunosuppressants and ocular hypotensive agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>This case suggests that severe scleral thinning and chronic inflammation compromised the anchoring of the iStent, resulting in migration and elevated IOP. This complication underscores the need for careful surgical planning in similar cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case underscores the complexities of managing secondary glaucoma in the context of refractory scleritis and highlights the critical need for meticulous surgical technique and rigorous postoperative follow-up to address potential complications such as iStent migration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.110997","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T02:32:46Z","timestamp":1738377166000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Case report on managing glaucoma with refractory scleritis: iStent complications and challenges"],"prefix":"10.1097","volume":"127","author":[{"given":"Mohammed","family":"Halawani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basil","family":"Alhussain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Alobaida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Schargel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-158-20260325","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1007\/s10792-015-0124-0","article-title":"Biologic therapy for refractory scleritis: a new treatment perspective","volume":"35","author":"de Fidelix,","year":"2015","journal-title":"Int. Ophthalmol."},{"key":"R2-158-20260325","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11926-020-0885-y","article-title":"Noninfectious autoimmune scleritis: recognition, systemic associations, and therapy","volume":"22","author":"Nevares,","year":"2020","journal-title":"Curr. Rheumatol. Rep."},{"key":"R3-158-20260325","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1136\/bjo.60.3.163","article-title":"Scleritis and episcleritis","volume":"60","author":"Watson,","year":"1976","journal-title":"Br. J. Ophthalmol."},{"key":"R4-158-20260325","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1136\/bjo.60.3.192","article-title":"Episcleritis and scleritis: a study of their clinical manifestations and association with rheumatoid arthritis","volume":"60","author":"McGavin,","year":"1976","journal-title":"Br. J. Ophthalmol."},{"key":"R5-158-20260325","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s10384-018-0600-y","article-title":"Clinical characteristics and ocular complications of patients with scleritis in Japanese","volume":"62","author":"Tanaka,","year":"2018","journal-title":"Jpn. J. Ophthalmol."},{"key":"R6-158-20260325","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1038\/s41433-022-02101-7","article-title":"Predictors of glaucoma in patients with uveitis and scleritis","volume":"37","author":"Niederer,","year":"2023","journal-title":"Eye"},{"key":"R7-158-20260325","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.2147\/OPTH.S135316","article-title":"Micro-invasive glaucoma surgery (MIGS): a review of surgical procedures using stents","volume":"11","author":"Pillunat,","year":"2017","journal-title":"Clin. Ophthalmol."},{"key":"R8-158-20260325","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.2147\/OPTH.S224109","article-title":"Comparison of surgical outcomes between excisional goniotomy using the Kahook dual blade and iStent trabecular micro-bypass stent in combination with phacoemulsification","volume":"13","author":"Lee,","year":"2019","journal-title":"Clin. Ophthalmol."},{"key":"R9-158-20260325","doi-asserted-by":"crossref","first-page":"677","DOI":"10.2147\/OPTH.S57217","article-title":"A review of the iStent\u00ae trabecular micro-bypass stent: safety and efficacy","volume":"9","author":"Wellik,","year":"2015","journal-title":"Clin. Ophthalmol."},{"key":"R10-158-20260325","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0183142","article-title":"Minimally-invasive glaucoma surgeries (MIGS) for open angle glaucoma: a systematic review and meta-analysis","volume":"12","author":"Lavia,","year":"2017","journal-title":"PLoS One"},{"key":"R11-158-20260325","first-page":"189","article-title":"Minimally invasive glaucoma surgery: current status and future prospects","author":"Richter,","year":"2016","journal-title":"Clin. Ophthalmol."},{"key":"R12-158-20260325","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.ophtha.2010.07.007","article-title":"Randomized evaluation of the trabecular micro-bypass stent with phacoemulsification in patients with glaucoma and cataract","volume":"118","author":"Samuelson,","year":"2011","journal-title":"Ophthalmology"},{"key":"R13-158-20260325","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.jcrs.2012.03.025","article-title":"Cataract surgery with trabecular micro-bypass stent implantation in patients with mild-to-moderate open-angle glaucoma and cataract: two-year follow-up","volume":"38","author":"Craven,","year":"2012","journal-title":"J Cataract Refract Surg"},{"key":"R14-158-20260325","doi-asserted-by":"crossref","first-page":"8294560","DOI":"10.1155\/2020\/8294560","article-title":"New potential weapons for refractory scleritis in the era of targeted therapy","volume":"2020","author":"Fabiani,","year":"2020","journal-title":"Mediat. Inflamm."},{"key":"R15-158-20260325","doi-asserted-by":"crossref","first-page":"3231","DOI":"10.2147\/OPTH.S316270","article-title":"Treatment success across different levels of preoperative disease burden: stratified two-year outcomes from the pivotal trial of iStent inject (\u00ae) trabecular micro-bypass in primary open-angle glaucoma and cataract","volume":"15","author":"Singh,","year":"2021","journal-title":"Clin. Ophthalmol."},{"key":"R16-158-20260325","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/IJG.0000000000002141","article-title":"Effectiveness and safety of iStent infinite trabecular micro-bypass for uncontrolled glaucoma","volume":"32","author":"Sarkisian,","year":"2023","journal-title":"J. Glaucoma"},{"key":"R17-158-20260325","doi-asserted-by":"crossref","first-page":"4152","DOI":"10.3390\/ijerph20054152","article-title":"Comparison of safety and efficacy of Hydrus and iStent combined with phacoemulsyfication in open angle glaucoma patients: 24-month follow-up","volume":"20","author":"Jab\u0142o\u0144ska,","year":"2023","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"R18-158-20260325","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0234690","article-title":"Intraocular and intracranial pressure in glaucoma patients taking acetazolamide","volume":"15","author":"Loiselle,","year":"2020","journal-title":"PLoS One"},{"key":"R19-158-20260325","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.jcjo.2017.11.009","article-title":"Methotrexate for the treatment of noninfectious scleritis","volume":"53","author":"Sands,","year":"2018","journal-title":"Can. J. Ophthalmol."},{"issue":"5","key":"R20-158-20260325","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1097\/JS9.0000000000000373","article-title":"The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi,","year":"2023","journal-title":"Int. J. Surg. (London, England)"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221026122500183X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S221026122500183X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.110997","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:25:02Z","timestamp":1774434302000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.110997"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":20,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2025.110997","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"2024-11-12","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-29","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}