Sterile corneal perforation after cataract surgery in Sjögren's syndrome

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.