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Case Reports
. 2019 Sep 12;9(3):202-205.
doi: 10.4103/tjo.tjo_3_19. eCollection 2019 Jul-Sep.

Bilateral corneal melting associated with topical diclofenac 0.1% after cataract surgery in a patient with Sjögren's syndrome

Pei-Ning Tu  1 , Yu-Chih Hou  1   2   3
Affiliations
Case Reports

Bilateral corneal melting associated with topical diclofenac 0.1% after cataract surgery in a patient with Sjögren's syndrome

Pei-Ning Tu et al. Taiwan J Ophthalmol. .

Abstract

A 79-year-old female with Sjögren's syndrome (SS) underwent phacoemulsification and lens implantation in both eyes within 2 days. Postoperatively, topical diclofenac 0.1% and tobramycin 0.3% were applied. She presented 10 days later with photophobia, large central corneal melting, and visual acuity of counting finger in both eyes. Diclofenac was discontinued, and systemic doxycycline and steroids were administered. Amniotic membrane transplantation was performed in the left eye with topical steroid and autologous serum 20%. Corneal melting gradually healed in 3 weeks, but the centers of both corneas became thin and opaque. Hyperopic shift and irregular corneal surface were more significant in the right eye than in the left eye. Vision recovered to 0.05 and 0.1 in the right and left eyes, respectively. Topical nonsteroidal anti-inflammatory drugs should be used with caution in cataract surgery in patients with SS.

Keywords: Amniotic membrane; Sjögren's syndrome; corneal ulcer; nonsteroidal anti-inflammatory agents; phacoemulsification.

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Conflict of interest statement

The authors declare that there are no conflicts of interests of this paper.

Figures

Figure 1
Figure 1
External photography showed bilateral hyperemia, and a large corneal melting measuring 5 mm × 6 mm in the right eye (a) and 7 mm × 8 mm in the left eye (b) Slit-lamp examination revealed central corneal edema, Descemet folds, and corneal thinning at inferior central area in the right (c) and the left (d) eyes
Figure 2
Figure 2
A sequela of a thin and opaque cornea occurred in the right (a) and the left (b) eyes. Anterior segment optical coherence tomography showed a higher hyperreflectivity of anterior stroma in the right cornea (c) than that in the left cornea, which had undergone amniotic membrane transplantation (d)
See this image and copyright information in PMC

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