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Toxic anterior segment syndrome: diagnosis and evolution approach

Poster Details

First Author: H.Santiago-Balsera SPAIN

Co Author(s):    M. Leal Gonzalez   M. Matilla Rodero   C. Carrasco Font   A. Arias Puente           

Abstract Details


To show the ability of the eye examination in the detection and subsequent treatment of complications not so common after cataract surgery as toxic anterior segment syndrome (TASS)


Two patients were examined at the Ophthalmology Department of Hospital Universitario Fundacion Alcorcon from Madrid, Spain


A cases report about TASS after left eye cataract surgery in 2 patients. Case 1: Visual acuity (VA): counting fingers (CF). Biomicroscopy (BMC): diffuse corneal edema from lymbus to lymbus with tyndall ++++ and IOL within the capsular sac. The Intraocular Pressure (IOP) is 46mmhg. Case 2: VA: CF. BMC: severe corneal edema with tyndall +++ and IOL in sac. The IOP is 40mmhg. The pachymetry is 790 and 730 microns respectively. The fundus does not present complications. In both cases, treatment is started with topical antibiotics and corticoids along with topical and oral hypotensors.


Two days later, fibrin is appeared in the anterior chamber along with fine diffused keratic precipitates. Given the suspicion of two TASS, it was decided to increase the topical treatment and begin systemic corticotherapy. One week later, persists corneal edema but without fibrin remnants. The IOP is controlled. Finally, after three weeks of systemic treatment, significant improvement is seen in both patients with VA: 0.6 (LogMar) and corneal transparency. Descending treatment is established. Pupillary arreactivity and endothelial cell deficit remain as a sequel in the second case


TASS is an uncommon acute, sterile, and inflammatory reaction that occurs 12-72 hours after anterior segment surgery. Its recognition, differentiating it from an endophthalmitis, allows the immediate start of treatment. The exhaustive control of all the steps during the surgery, the cleaning and sterilization of materials and instruments, and nurse training are very helpful in its prevention

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