title: [Corneal melting after ocular surgery in patients with auto-immune disorders].
abstract: Two women aged 78 and 74 years respectively, both with dry eyes due to underlying auto-immune disorders, presented after uncomplicated cataract surgery with immunostromal corneal ulceration. Intensive topical lubrication combined with systemic immunosuppressants were necessary to control the corneal melt. Dry eyes are a frequently-encountered problem among patients with rheumatoid disorders and increase the risk of corneal melting. Auto-immune related corneal melting can occur spontaneously or after ocular surgery, it threatens visual acuity and ocular integrity and may be associated with systemic vasculitis. When treating patients with rheumatoid disorders, the presence of dry eyes and the accompanying risk of serious complications need to be ascertained. In patients at risk, pre-operative preventive measures to suppress any underlying systemic disorders and improve the ocular environment are necessary. When corneal melting is diagnosed, aggressive topical therapy combined with systemic immunosuppressants is indicated.
authors.affiliation: Academisch Medisch Centrum/Universiteit van Amsterdam, Afd. Oogheelkunde, kamer A2123.1, Postbus 22.660, 1100 DD Amsterdam. i.j.vandermeulen@amc.uva.nl
authors.forename: I J E
authors.initials: IJ
authors.lastname: van der Meulen
authors.forename: J
authors.initials: J
authors.lastname: van Rooij
authors.forename: J W M
authors.initials: JW
authors.lastname: Hazes
authors.forename: H
authors.initials: H
authors.lastname: van Cleynenbreugel
authors.forename: A J M
authors.initials: AJ
authors.lastname: Geerards
authors.forename: L
authors.initials: L
authors.lastname: Remeyer
mesh_terms: D000287:Administration, Topical; D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications*; D002387:Cataract Extraction / Q000009:adverse effects*; D003316:Corneal Diseases / Q000188:drug therapy / Q000209:etiology*; D003320:Corneal Ulcer / Q000209:etiology; D015352:Dry Eye Syndromes / Q000150:complications / Q000276:immunology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D007166:Immunosuppressive Agents; D009883:Ophthalmic Solutions