Incidence and long-term outcomes of toxic anterior segment syndrome at Aravind Eye Hospital

Abstract

Although it is impossible to generalize for all etiologies, this study found that TASS is uncommon but not rare, responded to intensive topical antiinflammatory medication, and was usually associated with a good visual outcome. Anterior capsule contraction and PCO were the principal delayed-onset complications beyond those present 1 month postoperatively.

Intracameral recombinant tissue plasminogen activator (r-tPA) for refractory toxic anterior segment syndrome

“…It usually occurs acutely, but delayed onset has been reported as well 1. The incidence is variable with reported rates between 0.22%2 and 0.8%3 in different series. The most common finding is diffuse limbus-to-limbus corneal oedema secondary to damage from the toxic insult to the endothelial cell layer.…”

Toxic anterior segment syndrome: Update on the most common causes

“…A retrospective case series from Aravind Eye Hospital in India recently reported an incidence of 0.22% (60 eyes from 26 408 cataract surgeries). 1 Patients typically present within 12 to 48 hours postoperatively, and the most common finding is a diffuse limbus-to-limbus corneal edema secondary to damage of the endothelial cell layer. Widespread breakdown of the blood-aqueous barrier is also characteristic, with fibrin formation in the anterior chamber and increased anterior chamber inflammation, often resulting in a hypopyon.…”

Endophthalmitis or toxic anterior segment syndrome?

“…Clinicians should also be wary of the use of pain as a differentiating factor as pain in endophthalmitis is only present in about 75 per cent of patients . Furthermore, despite TASS being known to occur in clusters, Sengupta and colleagues found that 52 per cent of cases were sporadic. There is also often under‐reporting of sporadic cases.…”

“…Visual prognosis is usually excellent due to its responsiveness to topical steroids. Sengupta and colleagues found that the mean visual acuity (VA) was 0.11 logMAR (approximately 6/7.5 Snellen acuity) one month after treatment . Classic features of TASS include early (day zero or one post‐operatively), intense, painless anterior segment inflammation without vitreous involvement .…”