The evolution of toxic anterior segment syndrome

Shouchane-Blum, Karny; Dotan, Assaf; Bahar, Irit

doi:10.1097/icu.0000000000000540

Cited by 20 publications

(12 citation statements)

References 37 publications

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“…Previous studies evaluating risk factors for excessive anterior segment inflammation following cataract surgery have reported both preoperative factors (diabetes mellitus, pseudoexfoliation syndrome (PXF), history of uveitis, and glaucoma) 21 and intraoperative factors (inadequate flushing of phacoemulsification and irrigation/aspiration hand pieces, use of enzymatic cleansers, preserved epinephrine, skin prep agents, powdered gloves, and complicated surgery). 22,23 Therefore, in the current study, numerous additional causes may have potentially contributed to the high-grade inflammation. During the phacoemulsification technique in both groups, substances used prior, during, or following surgery were similar in the two groups.…”

Section: Discussionmentioning

confidence: 81%

Short-term anterior chamber inflammation in phacoemulsification with and without Ex-Press glaucoma implant

Graffi

Tiosano

Naftali

et al. 2019

European Journal of Ophthalmology

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Purpose: The aim of this study was to investigate the incidence of clinically significant anterior chamber inflammation in a combined surgery, namely, phacoemulsification and Ex-Press miniature glaucoma device implantation, compared to phacoemulsification alone. Methods: A retrospective comparative study of a consecutive series of 210 participants above 18 years of age diagnosed with significant cataract and who required glaucoma surgery, namely, Ex-Press miniature glaucoma device implantation or cataract alone in one or both eyes. All were operated on by a single experienced glaucoma surgeon in a single medical center. A total of 231 eyes were included in this study. All cases underwent an uneventful surgery and were examined the day following the surgery for visual acuity, intraocular pressure, and signs of excessive anterior chamber inflammation (Standardization of Uveitis Nomenclature grading ⩾ 3). Results: The combined group included 55 eyes of 51 patients, of whom 15 (27.3%) demonstrated excessive anterior chamber inflammation. The phacoemulsification group included 176 eyes of 159 patients, of whom 12 (6.7%) demonstrated excessive anterior chamber inflammation. Visual acuity and intraocular pressure measurements showed no statistically significant difference between the two groups. Conclusion: The Ex-Press glaucoma device is efficient, safe, and known for its inert nature. However, combination of this procedure with phacoemulsification surgery might result in a condition encouraging excessive inflammation, which eventually could lead to excessive anterior chamber inflammations if not treated vigorously. Emphasizing and recognizing the risks, especially in glaucoma patients, is important.

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Section: Discussionmentioning

confidence: 81%

Short-term anterior chamber inflammation in phacoemulsification with and without Ex-Press glaucoma implant

Graffi

Tiosano

Naftali

et al. 2019

European Journal of Ophthalmology

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“…Differenzialdiagnostisch abzugrenzen ist eine infektiöse postoperative Endophthalmitis, welche klinisch in aller Regel neben deutlichen Schmerzen und Photophobie durch eine schwere intraokulare Entzündungsreaktion insbesondere im hinteren Augenabschnitt (Vitritis) gekennzeichnet ist. Zeitlich manifestiert sich diese zudem im Mittel mit 4 bis 7 Tagen nach dem okulären Eingriff deutlich verzögert im Vergleich zu einer sterilen Endophthalmitis (12-48 h nach dem Eingriff) [9].…”

Section: Diskussionunclassified

Rezidivierende immunologische intraokulare Entzündungsreaktion nach intravitrealer operativer Medikamentengabe

et al. 2022

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“…Minute amounts of foreign substances may incite inflammation, and the large number and variety of surgical instruments used, as well as their different sterilization processes, make prevention challenging. Proper cleaning of surgical instruments and sterilization remain important for reducing rates of TASS (102).…”

Section: Perioperative Sterilization Considerationsmentioning

confidence: 99%

“…"Limbusto-limbus" corneal edema is characteristic of TASS and is uncommon for endophthalmitis. Other non-specific signs of anterior segment inflammation are common in both entities, such as anterior chamber cellular reaction, fibrin, and hypopyon (102).…”

Section: Introductionmentioning

confidence: 99%

Postoperative Endophthalmitis and Toxic Anterior Segment Syndrome Prophylaxis: 2020 Update

et al. 2020

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Improved surgical techniques have led to an increase in the number of outpatient ophthalmic procedures. In spite of decreased surgical times and overall improved outcomes, endophthalmitis remains one of the most severe complications of ophthalmic surgery. Although there are well known risk factors for postoperative endophthalmitis, some prophylaxis strategies remain controversial. A category of noninfectious postoperative inflammation, known as toxic anterior segment syndrome (TASS), is a rare but important complication of cataract surgery. While several worldwide outbreaks of TASS have occurred, it is challenging to identify an etiology in order to reduce the risk of further cases. Endophthalmitis and TASS cannot be prevented completely, but their rates may be decreased through risk reduction strategies supported by peerreviewed evidence. This review highlights the current evidence in the prevention strategies for postoperative endophthalmitis and TASS.

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The evolution of toxic anterior segment syndrome

Cited by 20 publications

References 37 publications

Short-term anterior chamber inflammation in phacoemulsification with and without Ex-Press glaucoma implant

Short-term anterior chamber inflammation in phacoemulsification with and without Ex-Press glaucoma implant

Rezidivierende immunologische intraokulare Entzündungsreaktion nach intravitrealer operativer Medikamentengabe

Postoperative Endophthalmitis and Toxic Anterior Segment Syndrome Prophylaxis: 2020 Update

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