ESCRS - PO026 - Management Of Severe Bilateral, Toxic Anterior Segment Syndrome After Immediate Sequential Bilateral Cataract Surgery

Management Of Severe Bilateral, Toxic Anterior Segment Syndrome After Immediate Sequential Bilateral Cataract Surgery

Published 2024 - 42nd Congress of the ESCRS

Reference: PO026 | Type: Case Report | DOI: 10.82333/1d6z-y052

Authors: Fahri Onur Aydin* 1 , Ali Ceylan 1 , Yusuf Berk Akbas 1 , Burcin KEPEZ YILDIZ 1 , Yusuf YILDIRIM 1

1Department of Ophthalmology,University of Health Sciences, Basaksehir Cam and Sakura City Hospital,Istanbul,Türkiye

Purpose

The frequency and popularity of immediate sequential bilateral cataract surgery (ISBCS) is increasing. We discuss the course of rehabilitation for a patient who had ISBCS and developed toxic anterior segment syndrome (TASS) in both eyes.

Setting

This study is a case report.

Report of case

The patient was a 42-year-old woman with no remarkable medical history and underwent ISBCS at another hospital in 2023. In that surgery, mitomycin C (MMC) was unintentionally given to the anterior chamber instead of carbachol (Miostat®) at the end of the surgery to both eyes. The next day after the surgery, she noticed vision loss and an ophthalmological examination revealed corneal edema in both eyes.  She was referred to our hospital with the diagnosis of bilateral TASS. Although the left eye began to improve after a week of medical treatment, the right eye's deterioration ended with Descemet membrane endothelial keratoplasty surgery. At the 2nd month postoperative visit, uncorrected distance visual acuity was 0.7 bilaterally, and both corneas were clear on slit lamp microscopy.

Conclusion/Take home message

Although ISBCS provides convenience in many areas, we believe that it should be performed only in particular indications and conditions because it may lead to severe problems such as bilateral blindness.