Intraocular and corneal complications of twenty patients undergoing cataract surgery who developed toxic anterior segment syndrome (TASS)

Session Details

Session Title: Presented Poster Session: Cataract Surgery Complications and Management IV

Session Date/Time: Sunday 06/09/2015 | 15:00-16:30

Paper Time: 15:30

Venue: Poster Village: Pod 1

First Author: : R.Nose BRAZIL

Co Author(s): :    A. Moriyama   A. Vidoris   D. Freitas        

Abstract Details

Purpose:

Report severe intraocular and corneal changes in a campaign for cataract surgery in São Paulo, Brazil, in which 20 patients were operated in the same day, and all patients suffered from toxic anterior segment syndrome(TASS) in the post-operative period.

Setting:

Ophthalmology and Visual Sciences Department, Paulista School of Medicine, Federal University of São Paulo, Brazil

Methods:

Twenty three patients underwent cataract surgery in a hospital in Sao Paulo, on June 8, 2014. After being diagnosed with TASS, most of them were sent and monitored in our service. We conducted prospective evaluations since the arrival of patients on August 10, 2014 until March 13, 2015. Patients were followed during this period, with complete ophthalmologic examination at all visits. And in some, surgical procedures were indicated.

Results:

At the first appointment all twenty patients presented with decreased visual acuity, corneal edema, Descemet folds, no anterior chamber reaction, iris in paralytic mydriasis and elevated intraocular pressure. Technically speaking, the phacoemulsification was unremarkable. After controlling intraocular pressure with drugs, corneal transplantation was indicated in all patients, to attempt to carry out iridoplasty. During the wait for the arrival of optical corneas, which usually takes two months in Sao Paulo, eighteen patients developed neurotrophic corneal ulcer. Of these patients, four had corneal perforation, requiring emergent keratoplasty. Three patients required blepharorraphy for the improvement of the trophic ulcer. Two patients without ulcer underwent DMEK and iridoplasty. All of them after the treatments, continued to present low visual acuity and glaucoma.

Conclusions:

Toxic anterior segment syndrome occurs usually within twenty-four hours after intraocular surgery, is a sterile ocular inflammation, presenting with several ocular signs and symptoms. May be related to various substances that are toxic to the eye. We report these serious cases of TASS with bad evolution, where patients experienced several intraocular and corneal complications. Despite the established clinical and surgical treatments, patients remained with low visual acuity and ocular sequelae. We emphasize the care required with the control and origins of materials used in eye surgery.

Financial Interest:

NONE