The strontium plaque emitting beta radiation that was used to treat the patients that we studied retrospectively was a 9-mm circular plaque. The surface area of this amounted to approximately 60 mm2 and indeed is significantly larger than that used by Dr Levine.1Dr Levine suggests that it may be the area of tissue irradiated that is important, since he has not seen the complications that we nor other authors have noted.2,3 However, a significant incidence of scleral necrosis with such differing areas of irradiation, as reported by ourselves and MacKenzie et al,3 still leads us to be concerned about any area undergoing irradiation with these doses following pterygium removal. Many of these patients required a latency period of some 15 to 20 years before presenting with scleral necrosis, and we hope that in the future this will not be Dr Levine's experience. In
Moriarty AP. Scleral Complications Following Beta Irradiation-Reply. Arch Ophthalmol. 1994;112(8):1016–1017. doi:10.1001/archopht.1994.01090200018004
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