NSAID-induced corneal melt as the first presentation of Sjögren’s syndrome
Ahmed, Lubna
Ahmed, Lubna
Abstract
A non-diabetic woman in her 80s presented 1 week following uncomplicated left eye cataract surgery complaining of decreased vision, gritty sensation and photophobia in the same eye. Postoperative treatment included G. Acular (Ketorolac Tromethamine 0.5%, NSAID: non-steroidal anti-inflammatory drug) and G. Tobradex (Tobramycin 0.3% and Dexamethasone 0.1%, antibiotic and steroid, respectively) each prescribed four times a day for 2 weeks. On examination, the patient had a corneal epithelial defect which progressed to a full-thickness perforation despite ceasing the NSAID drops. Cyanoacrylate glue application with a plastic drape patch failed to seal the perforation, and a full-thickness tectonic corneal transplant was performed. On investigation, the patient had positive anti-RO and anti-LA antibodies, suggesting a diagnosis of Sjögren’s syndrome. We advocate for careful preoperative assessment prior to cataract surgery, patient education, close follow-up and cautious medication use postoperatively including avoiding NSAID drops in patients with risk factors for postoperative dry eye disease.
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Date
2024
Type
Article
Subject
Cornea, Cataract
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Citation
Hammad, M., Ahmed, L., & Seifelnasr, M. (2024). NSAID-induced corneal melt as the first presentation of Sjögren's syndrome. BMJ case reports, 17(5), e258829. https://doi.org/10.1136/bcr-2023-258829