J Korean Ophthalmol Soc.  2011 Jun;52(6):690-695. 10.3341/jkos.2011.52.6.690.

Toxic Anterior Segment Syndrome Following Cataract Surgery

• Hwang KY
• Yang JW
• Lee YC
• Kim SY

• KMID: 2214640
• DOI: http://doi.org/10.3341/jkos.2011.52.6.690

Abstract

PURPOSE
To report clinical and laboratory findings of toxic anterior segment syndrome (TASS) in seven patients following cataract surgery with intraocular lens (IOL) implantation.
METHODS
The medical records of seven patients who underwent cataract surgery associated with postoperative decreased visual acuity, ocular pain, anterior chamber inflammation and corneal edema between Feb 2007 and Nov 2009 were retrospectively reviewed.
RESULTS
All patients were over 60 years of age, four patients had diabetes and four patients had cardiovascular disease. Five patients had received hydrophilic IOL, and six patients underwent surgery later in order. All seven patients presented with increased anterior segment inflammation, acute decreased visual acuity, and severe corneal edema an average of 10.4 days (range 1 to 15 days) after surgery. Treatment of the seven patients included intensive topical and oral steroids, and improvement was noted in all patients.
CONCLUSIONS
The incidence of TASS after cataract surgery was 0.8%, and was significantly higher in cases of hydrophilic IOL insertion (5 of 284 cases, 1.76%) compared to cases of hydrophobic IOL insertion (2 of 581 cases, 0.34%) (p = 0.04). Five of the seven cases presented with TASS at postoperative day 14. Inflammation improved in all patients with steroid treatment.

Keyword

Cataract surgery; Endophthalmitis; Hydrophilic IOL; Steroid; Toxic anterior segment syndrome

MeSH Terms

Anterior Chamber
Cardiovascular Diseases
Cataract
Corneal Edema
Endophthalmitis
Humans
Incidence
Inflammation
Lenses, Intraocular
Medical Records
Retrospective Studies
Steroids
Visual Acuity
Steroids

Figure

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  Figure 1. Photograph, 14 days after cataract surgery of case 1. Diffuse corneal edema, severe anterior chamber inflammation (A), and severe anterior capsule contracture (B) are observed.

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  Figure 2. Photograph, 1 day after cataract surgery of case 6. Diffuse corneal edema, severe anterior chamber inflammation, membranous deposit on the lens surface and hypopyons are observed.

Reference

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