Aim: To report cases of scleral necrosis after simple pterygium excision in which adjunctive treatment was not used.
Methods: We reviewed four patients who presented with scleral melt after pterygium excision without the use of adjunctive treatment in the form of beta irradiation, mitomycin C, or thiotepa. Each patient was thoroughly investigated to exclude underlying disease.
Results: Certain similarities were found between our patients with pterygium melt and cases of surgically induced necrotising scleritis including the location of melt, associated inflammation, and its response to steroid treatment in the latent period before they presented.
Conclusion: Bare sclera pterygium excision can cause surgically induced necrotising scleritis years after the surgery.