Tuck-in fibrin glue-assisted sutureless scleroplasty for post-pterygium surgery surgically induced necrotising scleritis: a novel technique

A woman in her 50s presented with redness and foreign body sensation in the left eye 3 months after pterygium excision. Slit-lamp examination revealed severe localised scleral thinning with nearly 90% tissue loss and visible underlying uveal hue in the nasal sclera. A novel sutureless fibrin glue-assisted tuck-in scleroplasty technique was performed using donor scleral tissue harvested from the corneoscleral rim of a donor cornea. A circumferential lamellar scleral groove was fashioned around the defect, and the graft edges were tucked into the groove and secured with fibrin glue without sutures. The overlying peritomy was closed using fibrin glue without harvesting additional conjunctival tissue. Postoperatively, the graft remained well apposed with restoration of scleral integrity and satisfactory conjunctival healing. This technique avoids suture-related complications and preserves healthy conjunctiva and limbal tissue, thereby potentially reducing the risk of donor-site morbidity and limbal stem cell deficiency.