Early successful treatment of postoperative necrotizing pseudomonas scleritis after trabeculectomy

Purpose: The authors describe a patient who developed pseudomonas scleritis after a routine trabeculectomy. Method: The patient underwent trabeculectomy for poorly controlled intraocular pressure and progressive visual field loss. On the second postoperative date he developed severe pain, significant anterior chamber reaction, and hypotony. Scleral cultures taken at the time of surgical choroidal drainage grew pseudomonas aeruginosa. Result: Surgical reconstruction of the necrotic scleral area and intensive antibiotic treatment lead to a successful outcome. Conclusion: Early recognition and aggressive treatment wtih antibiotics initially, followed by surgical debridement of necrotic tissue, resulted in an unexpected successful outcome in a patient with pseudomonas scleritis.