Posters

Bilateral corneal melting associated with topical diclofenac use following cataract surgery in a patient with Sjögren's syndrome

Poster Details

First Author: Y.Hou TAIWAN

Co Author(s):                        

Abstract Details

Purpose:

To report a case of bilateral acute corneal melting in a patient with Sjögren's syndrome after uneventful cataract surgery and the use of topical diclofenac 0.1% eyedrop.

Setting:

Department of Ophthalmology, National Taiwan University Hospital Department of Ophthalmology, Cathay General Hospital

Methods:

A 79-year old woman with Sjögren's syndrome underwent phacoemulsification and intraocular lens implantation in the left eye and the right eye within two days. Postoperatively, topical betamethasone 0.1%, diclofenac 0.1%, and tobramycin 0.3% were applied. Superficial punctate keratitis and photophobia occurred in both eyes two days later. Bilateral painless 6-mm corneal melting developed 10 days later and vision of both eyes decreased to counting finger.

Results:

Topical diclofenac 0.1% was discontinued. Schirmer's test demonstrated 1.0 mm in 5 minutes in both eyes. Preservative-free artificial tear and betamethasone 0.1%, and autologous serum 20% were applied. Oral doxycycline 200mg and prednisolone 30 mg daily were given. Amniotic membrane transplantation was done in the left eye and therapeutic contact lens was applied in both eyes. Conjunctival injection and corneal melting gradually subsided. Corneal epithelialization was completed within one month. Corneal topography showed markedly irregular surface in both eyes. Central corneas became thin and opaque with vision of 0.05 in the right eye and 0.1 in the left eye.

Conclusions:

Topical diclofenac can cause acute corneal melting and loss of vision after cataract surgery, especially in patients with Sjögren's syndrome. Cataract surgery should not be performed on both eyes with Sjögren's syndrome within a very short period of time.

Financial Disclosure:

None