Open AccessBilateral corneal melting associated with topical diclofenac 0.1% after cataract surgery in a patient with Sjögren's syndrome
Author(s) -
Pei-Ning Tu,
Yu-Chih Hou
Publication year - 2019
Publication title -
taiwan journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.519
H-Index - 9
eISSN - 2211-5072
pISSN - 2211-5056
DOI - 10.4103/tjo.tjo_3_19
Subject(s) - medicine , phacoemulsification , diclofenac , ophthalmology , photophobia , surgery , visual acuity , cataract surgery , tobramycin , intraocular lens , anesthesia , antibiotics , biology , gentamicin , microbiology and biotechnology
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.