Retrospective analysis of clinical characteristics of toxic anterior segment syndrome

Abstract

To investigate the etiology, clinical features, treatment and prognosis of toxic anterior segment syndrome (TASS). It was a retrospective series case study. The clinical data of eight definite diagnosed TASS cases were retrospectively analyzed. Among eight TASS cases, seven were post cataract surgery cases and one was post cornea penetrating injury. Three cases were caused by residual povidone iodine on instruments, 2 cases resulted from the misuse of distilled water as intraocular irrigating liquid during cataract surgery, 2 cases were produced by the countercurrent of antibiotic solution via the cornea-scleral incision into anterior chamber during subconjunctival injection at the end of the surgery, and 1 case was induced by the injection of the distilled water into the anterior chamber at the end of the surgery. Three TASS cases occurred during operation and 5 cases occurred at 1 day after operation. All eight cases suffered from the painless blurred vision. Three cases occurred during operation presented with decrease of corneal transparency and depigmentation of iris. On the first day after operation, all cases had diffuse corneal stroma edema and severe anterior uveitis. Dexamethasone 0.1% or prednisolone acetate 1% eye drops, three times per day or one time per hour was used in all cases. Carteolol 2% eye drop, two times per day, was used for the cases with ocular hypertension. The cornea was clear in 6 cases, but corneal endothelial decompensation in 2 cases after therapy. Various toxic agents injected into anterior chamber by misuse can result in TASS. All these misuse can be avoided. Early diagnosis and proper management may be important to improve the prognosis of TASS.