Comparison Of Systemic Inflammatory Indices In Patients With And Without Toxic Anterior Segment Syndrome
Published 2026 - 44th Congress of the ESCRS
Reference: POCAT143 | Type: Free paper | DOI: 10.82333/34eb-0b52
Authors: Dr Ecem Biskiner* 1 , Prof. Dr Aysun Sanal Dogan 1 , Dr Alperen Bahar 1 , Dr Bedia Kesimal 1 , Dr Beyza Tezel 1 , A/Prof. Osman Celikay 1
1Ophthalmology,University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital,Ankara,Türkiye
Purpose
Toxic anterior segment syndrome (TASS) is an acute sterile postoperative inflammatory reaction primarily attributed to intraocular toxic exposure. Whether systemic inflammatory status predisposes patients to TASS or influences disease severity remains unclear. In this study we aimed to evaluate whether systemic inflammatory indices differ between patients who developed TASS and those who did not.
Setting
University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Department of Ophthalmology, Ankara, Turkiye.
Methods
This retrospective case–control study included 30 patients who developed TASS following cataract surgery and 88 controls with uncomplicated postoperative courses. Preoperative complete blood counts were used to calculate neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII). Comparisons were performed using Mann–Whitney U tests with Holm correction. Multivariable logistic regression adjusted for age, sex and comorbidity status. Within the TASS cohort, fibrin reaction was analysed using Firth- penalised logistic regression. Receiver operating characteristic (ROC) analysis assessed discriminative performance.
Results
No significant differences were observed between TASS and controls for NLR, MLR, PLR or SII after correction for multiple comparisons (all adjusted p>0.05). Multivariable analysis demonstrated no independent association between any index and TASS occurrence. Among TASS patients, fibrin reaction occurred in 11 cases (36.7%). None of the inflammatory indices differed between fibrin-positive and fibrin-negative subgroups, and Firth-penalised models confirmed the absence of independent associations. ROC analyses showed poor discrimination (AUC range 0.36–0.52).
Conclusions
Systemic inflammatory indices derived from routine blood tests were found that they are not associated with either the development or severity (based on fibrin formation) of TASS. These findings support a predominantly local intraocular toxic mechanism in TASS pathophysiology.