Toxic anterior segment syndrome and possible association with ointment in the anterior chamber following cataract surgery

Werner, Liliana; Sher, Jeffrey H.; Taylor, Joel R.; Mamalis, Nick; Nash, Wesley A.; Csordas, James E.; Green, George; Maziarz, E. Peter; Liu, X. Michael

doi:10.1016/j.jcrs.2005.12.093

Cited by 111 publications

(93 citation statements)

References 18 publications

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“…It has previously been proposed that gaping wounds or a low IOP at the end of ocular surgery results in passive diffusion of fluid, which contains normal bacterial flora, from the ocular surface, through the wound and into the eye. 43,44 It may be possible that raised IOP following an intravitreal injection prevents this passive diffusion of fluid. Therefore, there would be a reduced likelihood of normal bacterial flora gaining access to the vitreous cavity with the potential to cause endophthalmitis.…”

Section: Risk Factorsmentioning

confidence: 99%

Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: incidence, features, risk factors, and outcomes

Lyall

Tey

Foot

et al. 2012

Eye

124

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Section: Risk Factorsmentioning

confidence: 99%

Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: incidence, features, risk factors, and outcomes

Lyall

Tey

Foot

et al. 2012

Eye

124

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“…However, it may rarely present as severe endothelial toxicity which may result in devastating complications. 10 Ünal and co-workers 6 reported 5 of 6 TASS patients undergoing penetrating keratoplasty. Our cases 1 and 2 were such cases that required PK.…”

Section: Discussionmentioning

confidence: 99%

“…Preservatives, detergents, denatured OVDs, incorrect chemical composition or pH, bacterial endotoxins, sterilizing agents, ophthalmic ointments have all been reported as responsible factors for the development of TASS. 2,10 A multicenter report has declared intrinsic endotoxin contamination of a particular balanced salt solution product to be the source of an outbreak of TASS. 5 Glutaraldehyde and EO gas sterilization were two other etiologic agents reported.…”

Section: Discussionmentioning

confidence: 99%

Toksik Ön Segment Sendromu için Yeni Bir Etken: Fibrin Yapıştırıcı

Küçükerdönmez¹,

Çetinkaya²,

Akova³

2014

tjo

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Amaç: Toksik ön segment sendromuna (TÖSS) yol açan olası bir etkeni sunmak. Gereç ve Yöntem: Komplikasyonsuz fakoemülsifikasyon ve göz içi lensi yerleştirilmesi sonrasında TÖSS gelişen 4 olgu sunulmaktadır. Bulgular: Olgular, 5 ay ara ile iki ayrı ameliyat gününün ilk iki olgusu idi. TÖSS'nin en belirgin bulgusu limbustan limbusa uzanan kornea ödemiydi. Ağrı ve/veya göz içi basınç artışı da diğer sık bulgulardı. İlk olaydan sonra tüm cerrahi ve cerrahi öncesi basamaklar gözden geçirildi; ikinci olaydan sonra daha detaylı araştırma gerekti. Önceki ameliyat gününün son vakası olan otogreftli piterjiyum cerrahisinden arta kalan fibrin yapıştırıcı artıklarının sorumlu etken olduğu bulundu. Yoğun kortikosteroid tedavisine rağmen 2 hastada kornea ödemi düzelmedi ve hastalara keratoplasti yapıldı. ÖzetObjectives: To present a potential cause for toxic anterior segment syndrome (TASS). Materials and Methods:We report 4 cases of TASS that occurred following uneventful phacoemulsification and intraocular lens implantation. Results: The 4 cases were the first consecutive 2 cases of 2 different surgery days, 5 months apart. The most prominent sign of TASS was limbus-to-limbus corneal edema. Pain and/or intraocular pressure rise were also common. All surgical and presurgical procedures were checked after the first outbreak, whereas the second outbreak required further investigation. Fibrin glue remnants from preceding pterygium surgery with conjunctival autografting were found to be the potential cause. Despite intensive corticosteroid therapy, corneal edema did not resolve in 2 patients who underwent keratoplasty. Conclusion: TASS is a sight-threatening condition which requires thorough investigation for prevention of new cases. All steps must be carefully revised. (Turk J Ophthalmol 2014; 44: 280-3)

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“…Yıkama sıvıları, göz içi anestezikler ve viskoelastik maddeler, kusurlu kimyasallar, ilaç konsantrasyonu, pH (<6,5 veya >8,5) ve osmolarite (<200 mOsm veya 400>mOsm), preservatifler veya göz ilaçları (antibiotik vs), bulaşık göz aletleri, deterjan artıkları (ultrasonik, sabunlar, enzimatik temizleyiciler), bakteriyel lipopolisakkaridler ve endotoksin, metal iyonları (bakır ve demir), kapsül boyaları (ICG, metilen mavisi), göz içi lensleri etyolojide sorumlu tutulan ajanlardır. 7 Operasyon sonrası 12-48 saatler içinde ortaya çıkan bu tabloda en sık görülen semptom ve bulgu, bulanık görme ve kornea ödemidir. Temel patolojinin kornea endotel hasarı olduğu düşünülür.…”

Section: Discussionunclassified

Fakoemulsifikasyon Sonrası Toksik Anterior Segment Sendromu

Dereli¹,

Takmaz²

2013

tjo

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Sum maryToxic anterior segment syndrome (TASS) caused by non-infectious agents is a sterile inflammation which occurs after anterior segment surgery and results in toxic damage to the intraocular tissues. Occurring within 12-48 hours after surgery, the most common symptoms and signs are blurred vision, corneal edema and inflammation. There are many agents accused in the etiology such as: irrigation fluids, improper sterilization of surgical instruments, ocular medications, and intraocular lens. Postoperative endophthalmitis is important in the differential diagnosis. In this article, a case of TASS seen after phacoemulsification surgery is discussed in terms of diagnosis, differential diagnosis, and treatment modality. (Turk J Ophthalmol 2013; 43: 377-80)

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Toxic anterior segment syndrome and possible association with ointment in the anterior chamber following cataract surgery

Abstract: The results indicate that the ointment gained access to the eye, causing the postoperative complications described. These cases highlight the importance of appropriate wound construction and integrity, as well as the risks of tight eye patching following placement of ointment.

Cited by 111 publications

References 18 publications

Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: incidence, features, risk factors, and outcomes

Post-intravitreal anti-VEGF endophthalmitis in the United Kingdom: incidence, features, risk factors, and outcomes

Toksik Ön Segment Sendromu için Yeni Bir Etken: Fibrin Yapıştırıcı

Fakoemulsifikasyon Sonrası Toksik Anterior Segment Sendromu

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