Episcleral pseudomelanoma: late complication of scleral tunnel incision

PURPOSE: To describe two patients who developed scleral thinning as a late complication of scleral tunnel incision for cataract extraction. DESIGN: Observational case report and interventional case report. METHODS: A 75-year-old man had an asymptomatic gray-brown subconjunctival nodule in the location of the healed scleral tunnel incision for cataract surgery. A 62-year-old man had a biopsy of a brown conjunctival nodule at the site of a scleral tunnel incision for cataract surgery. RESULTS: The 75-year-old patient with prolapsed uveal tissue was followed up for 4 years without change in the wound defect. The 62-year-old patient had a biopsy because the exposed ciliary body mimicked a melanoma. CONCLUSIONS: Scleral defects with herniated uveal tissue as a late sequela of scleral tunnel incision for cataract surgery should be differentiated from melanoma and can be safely observed for years when covered by conjunctiva.