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Chris HL Lim, Nathan Wong, Ching Hui Ng, Andrew Symons; Toxic Anterior Segment Syndrome in a tertiary Australian Healthcare Institution. Invest. Ophthalmol. Vis. Sci. 2017;58(8):786.
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© ARVO (1962-2015); The Authors (2016-present)
To report the clinical course and outcome of eyes affected by toxic anterior segment syndrome (TASS) in an Australian tertiary hospital, and discuss measures undertaken to minimise risk of further occurrences.
This was a retrospective case series with records of all eyes matching TASS case definition following cataract surgery from November 2011 to October 2012 included. Clinical features of presentation, treatment measures, and visual outcomes were recorded. The course of investigations and changes to cataract surgery flow at the hospital were described.
11 cases of TASS following cataract surgery were identified within a 12-month period. All eyes demonstrated features of TASS within 24 hours of surgery; specifically, diffuse corneal oedema and significant anterior chamber fibrin or hypopyon. Anterior chamber and vitreous tap was performed in 6 eyes, with no organism identified or grown from any sample. Visual acuity in all eyes improved post-operatively compared with pre-operative acuity. Changes to cataract surgery practices included replacement of instruments with disposable equivalents, modified sterilization methods with no lag time to re-sterilisation, and staff education. Following one isolated case after implemented changes, no further cases were seen.
This is the first published case series of TASS in an Australian tertiary care setting. Outbreaks of TASS require a multifaceted, multidisciplinary approach to identifying potential causative factors and implementing protocols to address these factors appropriately.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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