Toxic Anterior Segment Syndrome After an Uncomplicated Vitrectomy With Epiretinal Membrane Peeling

Abstract

Infectious endophthalmitis is the most devastating complication of eye surgery and is associated with severe inflammation of ocular tissues. This study aimed to present a similar condition, a case of toxic anterior segment syndrome (TASS) after an uncomplicated vitrectomy.A 69-year-old woman presented with epiretinal membrane and underwent 25-gauge pars plana vitrectomy with membrane peeling in her left eye. Thirty hours after the procedure, the patient complained of increasing loss of visual acuity and a red left eye. The ophthalmic examination revealed moderate hyperemia, hypopyon and snowbanks in the anterior vitreous. Subconjunctival and topical steroids were administered, and the inflammatory symptoms resolved within 30 days. The visual acuity improved to 20/32, however, cystoid changes were noted in the macula by optical coherence tomography.TASS should be considered a potential complication after vitrectomy. This report presents a case of TASS and discusses the differential diagnosis between TASS, infectious and non-infectious endophthalmitis.

Severe toxic anterior segment syndrome with ocular hypotony: a case report and literature review

“…In the TASS case,the etiology and toxic substances were not found. TASS often occurs after cataract surgery [11,12] , it also developed after other ocular surgeries such as keratoplasty [13] ,ICL implantation [14] , Trabeculectomy [15] , pterygium surgery [16] and posterior segment surgeries [17] .…”

Outbreak of toxic anterior segment syndrome following vitreoretinal surgery – A retrospective analysis

“…An isolated case of TASS was reported by Kanclerz[ 14 ] 30 h after pars plana vitrectomy for the epiretinal membrane. The author failed to indicate any specific agent in the causation.…”