Fungal scleral keratitis and endophthalmitis following pterygium excision.

PURPOSE The authors report a case of fungal scleral keratitis and endophthalmitis as a complication of pterygium surgery. METHODS Case presentation. RESULTS A 46-year old woman underwent pterygium excision with topical use of intraoperative mitomycin C. By day 21 after excision, scleral melting was followed by fungal keratitis. Endophthalmitis ensued, which rapidly progressed, despite surgical and medical interventions. The eye was finally enucleated to prevent fungaemia. Pathology revealed a highly disorganized eye with disruption of scleral collagen in the area of scleral melting. CONCLUSIONS Fungal keratitis and scleral melting are rare but devastating complications of pterygium surgery with adjuvant use of mitomycin C.