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¹S.B. Ankara Eğitim ve Araştırma Hastanesi,1.Göz Kliniği, Ankara, Asist. Dr.
²S.B. Ankara Eğitim ve Araştırma Hastanesi,1.Göz Kliniği Başasistanı, Ankara, Uzm. Dr.
³Mesa Hastanesi, Göz Hastalıkları Kliniği Direktörü, Ankara, Uzm. Dr.
⁴S.B. Ankara Eğitim ve Araştırma Hastanesi,1.Göz Kliniği Şef Yard, Ankara, Uzm.Dr.
⁵S.B. Ankara Eğitim ve Araştırma Hastanesi,1.Göz Kliniği Şefi, Ankara, Uzm. Dr. Purpose: To evaluate the etiology, clinical findings and management of toxic anterior segment syndrome (TASS), after anterior segment surgery.
Materials and Methods: Seven eyes of 7 patients who underwent uncomplicated phacoemulsification and intraocular lens implantation surgery by the same surgeon were included in this study. Toxic anterior segment syndrome was diagnosed after the surgery. The visual acuity, anterior and posterior segment examination and B-scan ultrasonography was performed in all patients. The onset, management, differential diagnosis of endophthalmi and potential causes of TASS were evaluated retrospectively.
Results: The mean age of the patients was 67.8±7.2 (57-73). The onset of TASS was within the first 24 hours in 5 cases and after 24 hours in 2 eyes. The visual acuity was hand movement perception in 3 eyes, count finger in 1 eye and light perception-projection in 1 eye. The intraocular pressure was above normal in one eye (27 mmHg). The most frequent clinical findings were tyndall phenomenon, corneal edema and hypopion, which were presen in all patients. The B-scan ultrasonogrpahy of the posterior segment was normal in all eyes. The use of ethylene oxide was determined for the re-sterilization of reusable tube in 4 patients, viscoelastic material in 2 patients and trypan blue dye in 1 patient. The signs and symptoms disappeared within 1 week, with oral methilprednisolone in 4 eyes, intravitreal dexamethazone in eye and intensive topical steroid treatment in all eyes
Conclusion: Ethylene oxide sterilisation of surgical devices is the potential cause of TASS development in these patients. Avoidance of ethylene oxide sterilisation and re-sterilisation of surgical devices will be an important measure to decrease TASS incidence. Keywords : Toxic anterior segment syndrome, phacoemulsification surgery, eyhtlene oxide sterilisation