July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The association of toxic anterior segment syndrome and intraocular pressure
Author Affiliations & Notes
  • Noa Geffen
    Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
    Ein Tal Medical Center, Israel
  • Karny Shouchane-Blum
    Ophthalmology , Rabin Medical Center , Ramat Hasharon, Israel
  • Assaf Gershoni
    Ophthalmology , Rabin Medical Center , Ramat Hasharon, Israel
  • Michael Mimouni
    Ophthalmology, Rambam Health Care Campus, Israel
  • Alon Zahavi
    Ophthalmology , Rabin Medical Center , Ramat Hasharon, Israel
  • Footnotes
    Commercial Relationships   Noa Geffen, None; Karny Shouchane-Blum, None; Assaf Gershoni, None; Michael Mimouni, None; Alon Zahavi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2406. doi:
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      Noa Geffen, Karny Shouchane-Blum, Assaf Gershoni, Michael Mimouni, Alon Zahavi; The association of toxic anterior segment syndrome and intraocular pressure. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2406.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : High intraocular pressure (IOP) is considered one of the characteristic signs of Toxic Anterior Segment Syndrome (TASS), although a review of the literature reveals scarce supporting evidence. The purpose of this study was to investigate the association of TASS and IOP.

Methods : A retromedical center between the years 201spective, controlled study of patients who developed TASS following a clear corneal incision cataract surgery performed at a single 0-2018.IOP was the primary endpoint whereas the need for hypotensive treatment was the secondary one. Exclusion criteria included patients with glaucoma, ocular hypertension, uveitis or infectious ocular disease, steroidal therapy and significant intraoperative complication. Student T tests and chi square were used to compare continuous and categorical outcomes respectively.

Results : There were 374 study eyes and 127 control eyes included in this study. The average time to the diagnosis of TASS was 9.5 days (range 1-63 days) with 83% defined as mild-moderate TASS and 17% severe. The study and control group were similar in terms of age (73.1±9.7 years versus 73.4±9.0 years, p = 0.70) and gender (40.6% male versus 34.7% male, p = 0.23). The mean IOP values measured in the study and the control groups at day 1 were 16.3±7.1 and 15.3±3.0 (p = 0.02), 13.2±5.0 and 13.7±2.9 (p = 0.18) at day 7 and 13.7±4.1 and 13.5±2.8 (p = 0.65) at day 30. Only 9% of the patients in the study group required an average range of 1.1-1.3 hypotensive medications at day 1, 3.7% at day 7 and 1.6% at day 30. The difference between the groups was statistically significant solely in patients with IOP > 21 mmHg at the first day post-surgery (12.7% and 3.2%, p= 0.002). However, this difference was no longer significant afterwards. Four patients (~1%) with TASS developed acute angle closure due to pupillary block 1-3 weeks post-surgery and required laser iridotomy and topical treatment.

Conclusions : Although high IOP is considered one of the main characteristics in the late stages of TASS, our results suggest that in the Israeli population, high IOP is expected only in a small group of TASS patients. Interestingly, this high IOP was documented in the early perioperative period.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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