Toxic anterior segment syndrome: A review

Hernández-Bogantes, Erick; Navas, Alejandro; Naranjo, Andrea; Amescua, Guillermo; Graue-Hernández, Enrique O; Flynn, Harry W.; Ahmed, Ike K.

doi:10.1016/j.survophthal.2019.01.009

Cited by 42 publications

(41 citation statements)

References 141 publications

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“…Toxic anterior segment syndrome is well described in human patients 9‐12,37 . It is defined as a sterile, postoperative inflammatory response caused by a noninfectious agent that enters the eye, specifically the anterior segment, and causes damage to intraocular tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Therapy with steroids usually results in clinical resolution 11,38,39 . With an increased incidence of TASS in physician ophthalmology over the last 25 years, the American Society of Cataract and Refractive Surgery (ASCRS) created a TASS task force in 2007 9 . The incidence of TASS in people is unknown, but overall, clusters of 3‐20 cases of TASS occur several times each year, translating to approximately 1 in 1000 following cataract surgery 9 .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Toxic anterior segment syndrome is a sterile postoperative inflammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in toxic damage to the intraocular tissues 9 . This phenomenon is noted in human ophthalmology and often spurs a thorough investigation of sterilization procedures, operating room equipment, and analysis of fluids and medications used during surgery 9‐12 . Reports of a TASS outbreak and subsequent investigation at Purdue University in 2014 (published in 2015 8 ) prompted immediate and significant changes in MU‐VHC surgical cataract protocols, specifically implementation of single use topical medications per each patient both preoperatively and postoperatively, disposable equipment wherever possible (including all cannulas, tubing material, single use disposable irrigation and aspiration (I/A) handpieces, all intracameral medications), use of thorough cleaning of our phacoemulsification handpieces with medical grade alcohol in addition to standard cleaning protocols to decrease the chances of endotoxin, implementation of the QuickRinse® (Advanced Optisurgical Inc) system for cleaning all luminal equipment that are not disposable, and a dedicated ultrasonic machine used only for our ophthalmology service.…”

Section: Introductionmentioning

confidence: 99%

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Characterization of postoperative “fibrin web” formation after canine cataract surgery

Dowler

Middleton

Dufour

et al. 2020

Veterinary Ophthalmology

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Purpose To describe the occurrence and associated factors for “fibrin web” (FW) formation following phacoemulsification in dogs. Methods A retrospective review of medical records of all dogs undergoing phacoemulsification (MU‐Veterinary Health Center, 2014‐2018) was conducted to associate FW formation with signalment, systemic co‐morbidities, cataract stage, surgeon (resident vs faculty), phacoemulsification time, IOL, and intracameral injections including viscoelastic type. Both univariate and multivariate statistical analyses were performed to evaluate associations among variables with FW formation. Results Data from 398 eyes on 201 dogs were included; 4 left eyes (4 dogs) developed presumptive endophthalmitis and were excluded from further analysis. Forty‐eight eyes did not have cataract surgery. Hence, 350 eyes on 201 dogs were included in the analyses. Among these, 84 eyes (59 dogs) developed a FW. Univariate analyses showed that the odds of FW increased with age and phacoemulsification time. Additionally, FW web was associated lens type, lens brand, and viscoelastic type. Multivariate analyses showed that when comparing lens types in combination with a particular viscoelastic, viscoelastic impacted the estimated prevalence of FW formation the most. In contrast, when the data were analyzed by lens brand, lens brand impacted prevalence more than viscoelastic type. Diabetes mellitus was not associated with FW formation. Conclusions Based on the available data, intraocular lens implantation, viscoelastic type, dog age, and phacoemulsification time were associated with FW formation. Diabetes mellitus, gender, cataract stage, surgeon, intracameral injections other than viscoeleastic, and intra‐ and postoperative complications were not associated with FW formation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Characterization of postoperative “fibrin web” formation after canine cataract surgery

Dowler

Middleton

Dufour

et al. 2020

Veterinary Ophthalmology

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“…Among potential causes of TASS, contamination of balanced salt solutions, osmotic concentration or ionic composition may be mentioned. Moreover, intraocular irrigating solutions with abnormal pH, denatured ophthalmic viscosurgical devices, intraocular antibiotics, metallic precipitates and topical ointments may also cause this intraocular inflammation [ 79 ]. The inadequate cleaning of intraocular surgery instruments, the use of enzymatic detergent in wrong concentrations, reutilization of products/instruments of single use and the lack of maintenance of autoclaves also pose a significant risk to patients [ 80 ].…”

Section: Guidelines For Cleaning and Sterilizationmentioning

confidence: 99%

Nanopharmaceuticals for Eye Administration: Sterilization, Depyrogenation and Clinical Applications

Zielińska

Soles

Lopes

et al. 2020

Biology

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As an immune-privileged target organ, the eyes have important superficial and internal barriers, protecting them from physical and chemical damage from exogenous and/or endogenous origins that would cause injury to visual acuity or even vision loss. These anatomic, physiological and histologic barriers are thus a challenge for drug access and entry into the eye. Novel therapeutic concepts are highly desirable for eye treatment. The design of an efficient ocular drug delivery system still remains a challenge. Although nanotechnology may offer the ability to detect and treat eye diseases, successful treatment approaches are still in demand. The growing interest in nanopharmaceuticals offers the opportunity to improve ophthalmic treatments. Besides their size, which needs to be critically monitored, nanopharmaceuticals for ophthalmic applications have to be produced under sterilized conditions. In this work, we have revised the different sterilization and depyrogenation methods for ophthalmic nanopharmaceuticals with their merits and drawbacks. The paper also describes clinical sterilization of drugs and the outcomes of inappropriate practices, while recent applications of nanopharmaceuticals for ocular drug delivery are also addressed.

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