Severe toxic anterior segment syndrome with ocular hypotony: a case report and literature review

Abstract

Background To report a rare case of severe toxic anterior segment syndrome with ocular hypotony after uneventful cataract surgery. Case presentation Toxic anterior segment syndrome (TASS) is an infrequent complication of ocular surgery.Here,we reported a rare TASS case with ocularhypotony after uneventful cataract surgery.A 62-year-old male was presented to our clinic for blurred vision in the right eye.The patient was diagnosed with age-related cataract and the phacoemulsification and intraocular lens implantation was performed uneventfully in the right eye.On the first postoperative day,the diffuse cornea edema and dilated pupil were present in the right eye with a tentative diagnosis of TASS.The medication administration was inffective in the case.The patient developed corneal decompensation 1 year after cataract surgery.Given the resulting corneal edema, the patient underwent Penetrating keratoplasty (PKP),fibrin membrane removal and goniosynechialysis were performed simultaneously.Ocularhypotony developed unexpectedly 2 weeks after PKP and maintained steadily in the case.Ultrasound biomicroscopy (UBM)showed the ciliary body atrophy.Optical coherence tomography (OCT)showed chorioretinal folds caused by hypotony maculopathy after PKP.To the best of our knowledge, we first reported the TASS case with ocularhypotony. Conclusions In the TASS case,the ocular hypotony was thought to be due to severe atrophy of ciliary body caused by uncertain toxic substance.