To report 2 patients with Sjögren syndrome (SS) who had no or mild dry eye symptoms preoperatively but developed severe and refractory dry eye after laser in situ keratomileusis (LASIK).
Two women with well-controlled early-stage SS developed severe dry eye, punctate epithelial keratopathy, and refractive regression 15 and 2 months after LASIK. Both patients were treated with punctal occlusions, artificial tears, fluorometholone 0.02% eyedrops, autologous serum, and systemic immunosuppressants.
Ten months after treatment, both patients exhibited only minor improvements in dry eye symptoms on the basis of changes in Schirmer test results, corneal fluorescein staining, and refractive errors, whereas their tear breakup time and corneal sensation remained unchanged.
Severe and refractory dry eye can develop after LASIK in patients with preexisting well-controlled early-stage SS.