Postoperative sterile endophthalmitis (TASS) associated with the MemoryLens

Jehan, Faisal; Mamalis, Nick; Spencer, Terrence S.; Fry, Luther L.; Kerstine, Richard S.; Olson, Randall J.

doi:10.1016/s0886-3350(00)00726-4

Cited by 80 publications

(66 citation statements)

References 6 publications

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“…Delayed onset TASS was associated with hydrophilic acrylic IOLs (memory lens). It was hypothesized that residual polishing compound on the memory lens was responsible for the postoperative inflammation [23]. However, a memory lens was not used in this case but rather an Alcon SN60WF.…”

Section: Discussionmentioning

confidence: 97%

Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

LoBue¹

2016

AOVS

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Purpose: To report an unusual case of sterile versus bacterial endophthalmitis in a post cataract surgery wound leak Subject: A 58-year-old woman with a past eye medical history of LASIK underwent routine cataract extraction (CE) with lens implant of left eye and presented with a delayed, fulminant endophthalmitis OS on day 19 post CE or 3.5 days after the development of a post-op wound leak. Eye examination OS showed visual acuity (VA) of bare LP. Slit lamp examination revealed an edematous cornea with a 1mm hypopyon. A large amount of exudate filled the entire posterior segment.Results: Patient was treated with intravitreal vancomycin (1mg) and ceftazidime (2mg) and pars plana vitrectomy. Vitreal cultures were negative, but initial clinical presentation mimicked a virulent strep, staph, or pseudomonas endophthalmitis. Her postoperative course showed gradual improvement, reaching baseline VA of 20/30 OS with a normal eye exam. Conclusion:Although culture-negative bacterial endophthalmitis is common, good visual outcomes with virulent bacteria is not. Fulminant culture-negative endophthalmitis with a good visual outcome may be due to a sterile toxic insult, a variation of TASS which we call Toxic Posterior Segment Syndrome (TPSS).

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Section: Discussionmentioning

confidence: 97%

Fulminant Culture Negative Endophthalmitis as a New Entity, Toxic Posterior Segment Syndrome?

LoBue¹

2016

AOVS

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“…Since 1980, there have been several reports of a severe form of anterior segment inflammation after cataract surgery that resulted in hypopyon formation and varying degrees of anterior segment damage from toxic substances. [1][2][3][4][5][6][7][8][9][10][11][12] This was initially referred to as sterile postoperative endophthalmitis, which is a misnomer since the inflammation primarily involves only the anterior segment of the eye (Figure 1). In 1992, Monson et al 6 accurately termed this condition toxic anterior segment syndrome (TASS).…”

Section: J Cataract Refract Surg 2006; 32:324-333 Q 2006 Ascrs and Escrsmentioning

confidence: 99%

“…Jehan et al 8 report 10 cases of a delayed-onset acute IOL inflammation following cataract surgery. In all patients, a hydrophilic acrylic IOL (MemoryLens) was implanted.…”

Section: Intraocular Lens-induced Inflammationmentioning

confidence: 99%

Toxic anterior segment syndrome

Mamalis

Edelhauser²,

Dawson³

et al. 2006

Journal of Cataract and Refractive Surgery

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269

192

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Toxic anterior segment syndrome (TASS) is a sterile postoperative inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in toxic damage to intraocular tissues. The process typically starts 12 to 48 hours after cataract/anterior segment surgery, is limited to the anterior segment of the eye, is always Gram stain and culture negative, and usually improves with steroid treatment. The primary differential diagnosis is infectious endophthalmitis. Review of the literature indicates that possible causes of TASS include intraocular solutions with inappropriate chemical composition, concentration, pH, or osmolality; preservatives; denatured ophthalmic viscosurgical devices; enzymatic detergents; bacterial endotoxin; oxidized metal deposits and residues; and factors related to intraocular lenses such as residues from polishing or sterilizing compounds. An outbreak of TASS is an environmental and toxic control issue that requires complete analysis of all medications and fluids used during surgery, as well as complete review of operating room and sterilization protocols.

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“…7,9 This case responded to steroids, with no inflammation at the end of four weeks of treatment. This further confirmed our diagnosis of TASS as postoperative endophthalmitis actually worsens with steroids.…”

Section: Discussionmentioning

confidence: 89%