Corneal Perforation After Uneventful Phacoemulsification Cataract Surgery In Undiagnosed Sjögren’S Syndrome

Unity of cornea and refracrive surgery, Ophtahlmology department , Military university hospital of constantine , Algeria

seventy-year-old female with a 30-days history of uncomplicated cataract surgery in her left eye, presented to our emergency department with complaints of painless blurred vision in the operated eye. He had no relevant medical history and was not currently taking any medication. The patient’s visual acuity was hand movement vision, slit-lamp examination showed a left central crescentic corneal melt with epithelial defect, a positive Seidel test and flat anterior chamber. Meticulous questioning revealed that this patient suffered from mild dry mouth and eyes before surgery and symptoms worsen after that. Some painful swelling was noticed as well. due of the severity of the condition, blood tests including inflammatory parameters, antinuclear antibody anti SSA were done and returned positive. A salivary gland biopsy showed typical lymphocytic sialadenitis.

A bandage soft contact lens was placed and topical antibiotics with preservative-free tears were added. Considering corneal melting due to an inflammatory systemic disease systemic, oral corticosteroid was initiated.  two weeks later, her BCVA had improved to 6/12. Cornea healed with paracentral stromal scar; a normal depth of anterior chamber recovered.

Acute sterile keratolysis after cataract extraction is a rare but serious complication. Meticulous preoperative assessment for both ocular and systemic risk factors is essential in this situation. The optimization of ocular surface prior to the surgery, a refined technique, and a close post-operative follow-up can avoid such a serious complication.