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Case Reports
. 2018 Jul 24:2018:bcr2018225428.
doi: 10.1136/bcr-2018-225428.

Corneal perforation in undiagnosed Sjögren's syndrome following topical NSAID and steroid drops post routine cataract extraction

Patrick Murtagh  1 , Richard Comer  2 , Gerry Fahy  1
Affiliations
Case Reports

Corneal perforation in undiagnosed Sjögren's syndrome following topical NSAID and steroid drops post routine cataract extraction

Patrick Murtagh et al. BMJ Case Rep. .

Abstract

A 74-year-old man presented with a progressive decrease in visual acuity and foreign body sensation in his right eye 8 days post uncomplicated phacoemulsification cataract surgery and intraocular lens insertion. The patient had been placed on a perioperative cataract regimen which consisted of G. Maxitrol (dexamethasone, polymyxin B sulfate, neomycin sulfate) four times a day and G. Yellox twice daily (bromfenac, a non-steroidal anti-inflammatory) for 2 weeks. On examination, he had a corneal ulcer and stromal thinning in his right eye which progressed to a full thickness perforation 12 hours later. The patient required a full thickness tectonic corneal transplant. Direct questioning revealed that this patient had both dry mouth and eyes. Serology revealed that the patient was positive for rheumatoid factor and for anti-Ro and anti-La antibodies. A parotid gland biopsy revealed significant lymphocytic infiltrate consistent with Sjögren's syndrome.

Keywords: anterior chamber; eye; ophthalmology; sjogren’s syndrome.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
25 days post penetrating keratoplasty. Graft completely re-epithelialised.
See this image and copyright information in PMC

References

    1. Lin JC, Rapuano CJ, Laibson PR, et al. . Corneal melting associated with use of topical nonsteroidal anti-inflammatory drugs after ocular surgery. Arch Ophthalmol 2000;118:1129–32. - PubMed
    1. Congdon NG, Schein OD, von Kulajta P, et al. . Corneal complications associated with topical ophthalmic use of nonsteroidal antiinflammatory drugs. J Cataract Refract Surg 2001;27:622–31. 10.1016/S0886-3350(01)00801-X - DOI - PubMed
    1. Asai T, Nakagami T, Mochizuki M, et al. . Three cases of corneal melting after instillation of a new nonsteroidal anti-inflammatory drug. Cornea 2006;25:224–7. 10.1097/01.ico.0000177835.93130.d4 - DOI - PubMed
    1. Sheppard JD. Topical bromfenac for prevention and treatment of cystoid macular edema following cataract surgery: a review. Clin Ophthalmol 2016;10:2099–111. 10.2147/OPTH.S86971 - DOI - PMC - PubMed
    1. Isawi H, Dhaliwal DK. Corneal melting and perforation in Stevens Johnson syndrome following topical bromfenac use. J Cataract Refract Surg 2007;33:1644–6. 10.1016/j.jcrs.2007.04.041 - DOI - PubMed

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