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Billateral scleral dellen following strabismus surgery: case report of 2 years follow up

Ni Made Ayu Surasmiati , Ni Made Gita Saraswati, I Gusti Ayu Ratna Suryaningrum, I Gusti Ayu Made Juliari, Niti Susila Ni Ketut

Ni Made Ayu Surasmiati
Department of Ophthalmology, Udayana University Sanglah Hospital Denpasar Bali. Email: selfacuity@yahoo.com

Ni Made Gita Saraswati
Department of Ophthalmology, Udayana University Sanglah Hospital Denpasar Bali

I Gusti Ayu Ratna Suryaningrum
Ophthalmology Department, Faculty of Medicine Udayana University, Sanglah Hospital, Bali

I Gusti Ayu Made Juliari
Ophthalmology Department, Faculty of Medicine Udayana University, Sanglah Hospital, Bali

Niti Susila Ni Ketut
Ophthalmology Department, Faculty of Medicine Udayana University, Sanglah Hospital, Bali
Online First: September 18, 2019 | Cite this Article
Ayu Surasmiati, N., Gita Saraswati, N., Suryaningrum, I., Juliari, I., Ni Ketut, N. 2019. Billateral scleral dellen following strabismus surgery: case report of 2 years follow up. Bali Journal of Ophthalmology 2(2). DOI:10.15562/bjo.v2i2.29


Dellen are small saucer-like excavations could happened at cornea and sclera. Scleral dellen result from local dehydration and thinning of the scleral tissues with exposure of the underlying uvea leading to their bluish color. This condition has been reported occured after a variety of ocular surgical procedures, including strabismus surgery, pterygium excision  and cataract extraction. The incidence of scleral dellen has not yet known, but data regarding dellen cornea are estimated at 3.2-4.3% in general strabismus surgery. The purpose of this case report is to study scleral dellen as a post-operative extraocular muscle complication and its treatment.

Patient, male, 12 years old with intermittent exotropia has performed bilateral lateral rectus recess with adjustable suture. Postoperative ocular alignment was orthophoria, but scleral dellen was found in both eyes after surgery. Rheumatoid factor examination and Anti-Nuclear Antibody tests were performed to confirm the presence of collagen abnormalities and autoimmune diseases showing normal results. No deterioration until 2 years follow up. Patients were treat conservatively.

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