Abstract
Painless, sterile, noninfiltrated corneal ulceration and perforation, which may occur after recent cataract surgery in patients with rheumatoid arthritis, and Sjögren's syndrome, appears to be a distinct clinical entity. The cause is probably multifactorial. Contributing factors may be the underlying systemic disease process in rheumatoid arthritis and Sjögren's syndrome, the associated keratoconjunctivitis sicca, the surgical procedure, and the postoperative use of oral and topical corticosteroids. Two cases of this clinical entity are reported here. Preoperative recognition by cataract surgeons that corneas in patients with rheumatoid arthritis and Sjögren's syndrome have an increased risk for postoperative ulceration should prompt postoperative preventive measures.
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- Arentsen J. J., Christiansen J. M., Maumenee A. E. Marginal ulceration after intracapsular cataract extraction. Am J Ophthalmol. 1976 Feb;81(2):194–197. doi: 10.1016/0002-9394(76)90730-3. [DOI] [PubMed] [Google Scholar]
- Aronson S. B., Elliott J. H., Moore T. E., Jr, O'Day D. M. Pathogenetic approach to therapy of peripheral corneal inflammatory disease. Am J Ophthalmol. 1970 Jul;70(1):65–90. doi: 10.1016/0002-9394(70)90670-7. [DOI] [PubMed] [Google Scholar]
- Bloomfield S. E., Becker C. G., Christian C. L., Nauheim J. S. Bilateral necrotising scleritis with marginal corneal ulceration after cataract surgery in a patient with vasculitis. Br J Ophthalmol. 1980 Mar;64(3):170–174. doi: 10.1136/bjo.64.3.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brown S. I., Grayson M. Marginal furrows. A characteristic corneal lesion of rheumatoid arthritis. Arch Ophthalmol. 1968 May;79(5):563–567. doi: 10.1001/archopht.1968.03850040565011. [DOI] [PubMed] [Google Scholar]
- Donshik P. C., Berman M. B., Dohlman C. H., Gage J., Rose J. Effect of topical corticosteroids on ulceration in alkali-burned corneas. Arch Ophthalmol. 1978 Nov;96(11):2117–2120. doi: 10.1001/archopht.1978.03910060497024. [DOI] [PubMed] [Google Scholar]
- Gudas P. P., Jr, Altman B., Nicholson D. H., Green W. R. Corneal perforations in Sjögren syndrome. Arch Ophthalmol. 1973 Dec;90(6):470–472. doi: 10.1001/archopht.1973.01000050470014. [DOI] [PubMed] [Google Scholar]
- Krachmer J. H., Laibson P. R. Corneal thinning and perforation in Sjögren's syndrome. Am J Ophthalmol. 1974 Dec;78(6):917–920. doi: 10.1016/0002-9394(74)90801-0. [DOI] [PubMed] [Google Scholar]
- Lyne A. J. "Contact lens" cornea in rheumatoid arthritis. Br J Ophthalmol. 1970 Jun;54(6):410–415. doi: 10.1136/bjo.54.6.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Moutsopoulos H. M., Chused T. M., Mann D. L., Klippel J. H., Fauci A. S., Frank M. M., Lawley T. J., Hamburger M. I. Sjögren's syndrome (Sicca syndrome): current issues. Ann Intern Med. 1980 Feb;92(2 Pt 1):212–226. doi: 10.7326/0003-4819-92-2-212. [DOI] [PubMed] [Google Scholar]
- Pfister R. R., Murphy G. E. Corneal ulceration and perforation associated with Sjögren's syndrome. Arch Ophthalmol. 1980 Jan;98(1):89–94. doi: 10.1001/archopht.1980.01020030091006. [DOI] [PubMed] [Google Scholar]
- Radtke N., Meyers S., Kaufman H. E. Sterile corneal ulcers after cataract surgery in keratoconjunctivitis sicca. Arch Ophthalmol. 1978 Jan;96(1):51–52. doi: 10.1001/archopht.1978.03910050015003. [DOI] [PubMed] [Google Scholar]
- Saracco J. B., Arneodo J., Fourcade, Cornand A. Kératomalacie avec porforation bilatérale au cours d'une polyarthrite rhumatoïde. Bull Soc Ophtalmol Fr. 1973 Jan;73(1):217–220. [PubMed] [Google Scholar]
- Schulz E., von Domarus D. Bindehaut-Sklera-Hornhautulzeration nach Kataraktextraktion. Klin Monbl Augenheilkd. 1979 May;174(5):694–699. [PubMed] [Google Scholar]