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Outcome of anterior chamber irrigation in a patient with TASS unresponsive to steroids

Poster Details

First Author: M.Acar TURKEY

Co Author(s):    N. Unlu   R. Goktas   G. Uney   D. Hazirolan   F. Ornek  

Abstract Details

Purpose:

To report the outcome of anterior chamber (AC) irrigation in a case with toxic anterior segment syndrome (TASS) unresponsive to steroids which developed after phacoemulsification (PE) with foldable intraocular lens (IOL) implantation surgery.

Setting:

Department of Ophthalmology, Ankara Training and Research Hospital.

Methods:

Case presentation of a forty-years-old female patient with bilateral cataracts. Both eyes had uneventful PE surgery with foldable IOL implantation. Visual acuity (VA) in left eye which was operated first impoved to 20/20. On the first day after the operation the VA in the right eye was at a level of counting fingers at 1 m, the intraocular pressure was 12 mmHg, no pain, no hyperemia in conjunctiva, mild corneal edema, 4+ cells and hypopyon (2mm) in the AC, the red reflex was poor and the fundus was not visible.

Results:

On the first postsurgical day the treatment was continued with subconjunctival injection of dexamethasone, topical prednisolon asetate 1% hourly. The VA and clinical findings were the same in the second and third days of the surgery.On the third day AC was irrigated with BSS using a single use AC cannula. The hypopyon was removed, posterior chamber and the capsular bag was also irrigated. The VA improved to 20/50 in the next day and 20/20 after 2 days. The topical medication was tapered in the following weeks without any recurrent inflammation.

Conclusions:

Anterior chamber irrigation in TASS is not a well defined form of treatment in the literature. Irrigation may help to remove inflammatory and toxic material in the anterior segment and may be considered as an option in cases unresponsive to steroid treatment. In our case enzymatic detergent which was changed at the day of the surgery was suspected as the cause for TASS. The surgical instruments need to be properly rinsed after the use of any enzyme or detergent. We discontinued the use of this enzymatic cleaner without any further TASS case.

Financial Disclosure:

NONE

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