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Qi H, Xie X, Zhang Q. Presumed atypical late-onset toxic anterior segment syndrome after implantable collamer lens implantation: a case report. BMC Ophthalmol 2024; 24:347. [PMID: 39148038 PMCID: PMC11328355 DOI: 10.1186/s12886-024-03615-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 08/06/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Toxic anterior segment syndrome (TASS) is a rare, noninfectious inflammation that occurs after anterior segment surgery. We report a case herein that developed presumed atypical late-onset TASS after V4c implantable collamer lens (ICL) implantation surgery. CASE PRESENTATION A 26-year-old man underwent ICL implantation surgeries of both eyes on two separate days. The 1-day and 7-day postoperative routine follow-up visits revealed no abnormalities. However, one month after surgery, dense white spots attached to the posterior surface and scattered ones to the anterior surface of ICL in the left eye were noted on anterior segment examination. His uncorrected distance visual acuity (UDVA) was 20/16 in both eyes and the fundus examination was normal. Despite the absence of typical clinical manifestations, late-onset TASS was suspect and intense topical steroid was administered. After 6 weeks of tapering topical steroid therapy, the white spots disappeared and the patient had no subjective complains throughout the treatment period. CONCLUSIONS This case suggested that the traditionally considered acute and serious TASS could also present as delayed and insidious onset after ICL implantation surgery. Due to its variabilities, the awareness of TASS should be raised to ophthalmologists and regular follow-up visits should be emphasized to patients. Once TASS was suspected, intensive steroid therapy should be implemented in time.
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Affiliation(s)
- Hang Qi
- Refractive Surgery Center, Wuhan Aier Ophthalmology Hospital, No.481, Zhongshan Road, Wuhan, Hubei, China
| | - Xiuli Xie
- Refractive Surgery Center, Wuhan Aier Ophthalmology Hospital, No.481, Zhongshan Road, Wuhan, Hubei, China
| | - Qingsong Zhang
- Refractive Surgery Center, Wuhan Aier Ophthalmology Hospital, No.481, Zhongshan Road, Wuhan, Hubei, China.
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Gong D, Deng S, Dang K, Yan Z, Wang J. Causes and management strategies for elevated intraocular pressure after implantable collamer lens implantation. Front Med (Lausanne) 2024; 11:1351272. [PMID: 38384405 PMCID: PMC10879591 DOI: 10.3389/fmed.2024.1351272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/25/2024] [Indexed: 02/23/2024] Open
Abstract
With the widespread application of Implantable Collamer Lens (ICL) implantation surgery in the field of myopia correction, a comprehensive understanding of its potential complications, especially those related to intraocular pressure (IOP), becomes crucial. This article systematically reviews various complications that may lead to IOP elevation after ICL surgery. Firstly, common complications after ICL surgery, including residual viscoelastic, steroid response, and excessive vault of the ICL, are detailed, emphasizing their potential impact on intraocular pressure. Regarding residual viscoelastic, we delve into its direct relationship with postoperative elevated IOP and possible preventive measures. For steroid response, we stress the importance of timely adjustment of steroid therapy and monitoring intraocular pressure. Additionally, excessive vault of the ICL is considered a significant potential issue, and we elaborate on its mechanism and possible management methods. In further discussion, we focus on relatively rare complications such as Toxic Anterior Segment Syndrome (TASS), Urrets-Zavalia Syndrome (UZS), Pigment Dispersion Syndrome (PDS), and malignant glaucoma. For these relatively rare complications, this review thoroughly explores their potential mechanisms, emphasizes the importance of prevention, and provides guidance for early diagnosis and treatment. This is a comprehensible review that aims to offer eye care professionals a comprehensive understanding and effective management guidance for complications of elevated IOP after ICL surgery, ultimately providing optimal care for patients' visual health.
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Affiliation(s)
- Di Gong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Simin Deng
- The 2nd Clinical Medical College (Shenzhen People's Hospital) of Jinan University, Shenzhen, China
| | - Kuanrong Dang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Zonghui Yan
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
| | - Jiantao Wang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, Guangdong, China
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Verma L, Malik A, Maharana PK, Dada T, Sharma N. Toxic anterior segment syndrome (TASS): A review and update. Indian J Ophthalmol 2024; 72:11-18. [PMID: 38131565 PMCID: PMC10841787 DOI: 10.4103/ijo.ijo_1796_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/18/2023] [Accepted: 09/09/2023] [Indexed: 12/23/2023] Open
Abstract
Toxic anterior segment syndrome (TASS) is an acute, sterile, postoperative inflammatory reaction of the anterior segment without vitreous involvement, following an uncomplicated and uneventful ocular surgery, having broad and multiple etiologies. The symptoms of decreased visual acuity and ocular discomfort generally occur within the first 12-48 h after intraocular surgery. The clinical signs include prominent limbus-to-limbus corneal edema, anterior chamber cells, aqueous flare, fibrinous inflammation, and/or keratic precipitates. There can be sight-threatening complications of TASS, such as permanent corneal decompensation, intractable glaucoma, and cystoid macular edema. The causes of TASS are emerging and being reported, so are the newer treatment options for managing the inflammation and its complications. Prevention guidelines for TASS are being updated, and a traceability system for surgical instruments and intraocular fluids used during the surgery is being perpetually developed. It is important to recognize TASS and start treatment on an immediate effect. Hereby, we review the literature on TASS, emphasizing its etiology, pathophysiology, management, prognosis, complications, and the importance of prevention as well as prompt recognition.
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Affiliation(s)
- Lalit Verma
- Consultant Ophthalmologist, Vitreoretinal Services, Centre for Sight, Safdarjung Enclave, New Delhi, India
| | - Anu Malik
- Cornea and Refractive Surgery Services, Dr. R. P. Centre of Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Prafulla K Maharana
- Cornea and Refractive Surgery Services, Dr. R. P. Centre of Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Tanuj Dada
- Cornea and Refractive Surgery Services, Dr. R. P. Centre of Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Namrata Sharma
- Cornea and Refractive Surgery Services, Dr. R. P. Centre of Ophthalmic Sciences, AIIMS, New Delhi, India
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Li L, Zhou Q. Late-onset toxic anterior segment syndrome after ICL implantation: two case reports. BMC Ophthalmol 2023; 23:61. [PMID: 36774473 PMCID: PMC9921073 DOI: 10.1186/s12886-022-02713-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 11/26/2022] [Indexed: 02/13/2023] Open
Abstract
BACKGROUND Toxic anterior segment syndrome (TASS) is a non-infectious inflammation that can occur after any anterior segment procedure. This case report presents two relatively rare late-onset TASS cases after V4c implantable collamer lens (ICL) operation. CASE PRESENTATION One 25-year-old woman and one 31-year-old woman suddenly had vision loss in monocular for 1 week after biocular V4c ICL operations and with no subjective complaints. They both presented fibrin formation in the anterior chamber such as keratic precipitates and white pus on the surface of the ICL. Fundus examination was normal. After 4 to 5 weeks of topical and oral steroid treatment, visual acuity and fibrin formation in the anterior chamber improved during the follow-up. CONCLUSIONS TASS should be suspected in any patient during the late period following ICL surgery; Once TASS is diagnosed, adequate treatment with intensive steroid therapy can be implemented.
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Affiliation(s)
- Li Li
- Refractive Surgery Center, Chongqing Eye and Vision Care Hospital, Yuzhong District, NO.77, the second Changjiang Road, Chongqing, China
| | - Qizhi Zhou
- Refractive Surgery Center, Chongqing Eye and Vision Care Hospital, Yuzhong District, NO.77, the second Changjiang Road, Chongqing, China.
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Mandal S, Sahay P, Tripathi M, Maharana PK. Complications following implantation of posterior chamber phakic intraocular lens (pIOL). BMJ Case Rep 2022; 15:e253876. [PMID: 36593609 PMCID: PMC9730352 DOI: 10.1136/bcr-2022-253876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
A male patient in his 20s presented with right eye aphakic corneal decompensation and left eye intumescent cataract with phakic intraocular lens (pIOL) lenticular touch. He had a history of pIOL implantation in both eyes 6 months ago. On first postoperative day, uncorrected distance visual acuity was 20/400 and 20/20 in right and left eye, respectively. Postoperatively, a diagnosis of right eye toxic anterior segment syndrome (TASS) was made and pIOL was explanted. Subsequently, the patient developed intumescent cataract for which lens aspiration with posterior chamber intraocular lens (PCIOL) implantation was performed in the right eye. Ongoing uveitis with membrane formation warranted PCIOL explantation. The patient developed aphakic corneal decompensation in the right eye and underwent penetrating keratoplasty with intrascleral haptic fixation of an intraocular lens. Central pIOL-lenticular touch with intumescent cataract was diagnosed in the left eye for which pIOL explant with lens aspiration and PCIOL was done. TASS and post-pIOL cataract are rare but vision-threatening complications require judicious management for visual rehabilitation.
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Affiliation(s)
- Sohini Mandal
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Pranita Sahay
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Manasi Tripathi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Prafulla Kumar Maharana
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Dr RP Centre for Ophthalmic Sciences, New Delhi, Delhi, India
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Zhang H, Gong R, Zhang X, Deng Y. Analysis of perioperative problems related to intraocular Implantable Collamer Lens (ICL) implantation. Int Ophthalmol 2022; 42:3625-3641. [PMID: 35731355 PMCID: PMC9587946 DOI: 10.1007/s10792-022-02355-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/18/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To introduce a modified procedure of ICL implantation, to summarize the perioperative problems and their corresponding treatment after myopia correction with Implantable Collamer Lens (ICL), and to compare the difference of complications between the no-hole ICL and hole ICL. METHODS We searched all articles on ICL-related perioperative problems and their corresponding treatment in Scopus, Embase, PubMed and Web of Science databases for the last 22 years. RESULTS ICL implantation is safe, effective, stable and predictable in the correction of myopia, hyperopia and astigmatism, but can also cause a series of perioperative problems, including intraoperative and postoperative complications. CONCLUSION There are many kinds of complications related to ICL, but the common intraoperative and postoperative complications mainly include abnormality of arch height, abnormal position of ICL, loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma, cataract and night vision symptoms. Compared with ICL without central pore, the incidence of complications such as loss of corneal endothelial cells and corneal decompensation, high intraocular pressure and secondary glaucoma and cataract was relatively lower in central hole ICL, while postoperative complications such as night vision symptoms were obvious.
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Affiliation(s)
- Hao Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Rui Gong
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Xiaolan Zhang
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
| | - Yingping Deng
- Department of Ophthalmology, West China Hospital, Sichuan University, No.37, Guoxue Xiang, Chengdu, 610041 Sichuan China
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Pintiliuc C, Ricaud X, Costantini E. Toxic anterior segment syndrome following EyePCL implantation in a hyperopic patient. J Fr Ophtalmol 2022; 45:272-276. [DOI: 10.1016/j.jfo.2021.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/03/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
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Gupta PK, Berdahl JP, Chan CC, Rocha KM, Yeu E, Ayres B, Farid M, Lee WB, Beckman KA, Kim T, Holland EJ, Mah FS. The corneal endothelium: clinical review of endothelial cell health and function. J Cataract Refract Surg 2021; 47:1218-1226. [PMID: 34468459 DOI: 10.1097/j.jcrs.0000000000000650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 02/19/2021] [Indexed: 12/17/2022]
Abstract
The endothelial cell is a critical structure within the cornea and is responsible for maintaining corneal clarity through its pump function. Endothelial cells are lost over time naturally but can be injured medically, surgically, or as a part of various dystrophies. Monitoring of endothelial cells can be performed clinically or more formally with specular microscopy. In cases of significant compromise, endothelial cells can be transplanted by various endothelial keratoplasty techniques. The future pipeline is bright for possible endothelial cell regeneration and rehabilitation. This article reviews these topics in depth to provide a comprehensive look at the structure and function of the endothelial cell, etiologies of endothelial cell damage, detailed review of iatrogenic causes of endothelial cell loss, and management strategies.
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Affiliation(s)
- Preeya K Gupta
- From the Department of Ophthalmology, Duke Eye Center, Durham, North Carolina (Gupta, Kim); Vance Thompson Vision, Sioux Falls, South Dakota (Berdahl); Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada (Chan); Medical University of South Carolina, Storm Eye Institute, Charleston, South Carolina (Rocha); Virginia Eye Consultants, Norfolk, Virginia (Yeu); Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania (Ayres); Gavin Herbert Eye Institute, University of California-Irvine, Irvine, California (Farid); Eye Consultants of Atlanta and Georgia Eye Bank, Atlanta, Georgia (Lee); Comprehensive EyeCare of Central Ohio, Westerville, Ohio (Beckman); Department of Ophthalmology, The Ohio State University, Columbus, Ohio (Beckman); Cincinnati Eye Institute and the University of Cincinnati, Cincinnati, Ohio (Holland); Scripps Clinic Medical Group, La Jolla, California (Mah)
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Mimouni M, Alió Del Barrio JL, Alió JL. Occlusion of AquaPORT Flow in a Case of Toxic Anterior Segment Syndrome Following Implantable Collamer Lens Surgery Causing Severe Pupillary Block. J Refract Surg 2021; 36:856-859. [PMID: 33296000 DOI: 10.3928/1081597x-20201015-01] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 10/14/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To present a case where following Implantable Collamer Lens (ICL) implantation the patient developed toxic anterior segment syndrome (TASS) with a subsequent pupillary block as a consequence of the occlusion of the AquaPORT (STAAR Surgical) flow hole. METHODS Case report and literature review. RESULTS A V4c toric ICL (STAAR Surgical) was implanted in the left eye of a 32-year-old woman. After 1 week, the lens was 15° off axis and uneventful lens alignment correction was performed. At postoperative day 1, an intraocular pressure (IOP) of 11 mm Hg and mild corneal edema were observed. At postoperative day 7, there was an uncorrected distance visual acuity of 20/800, an IOP of 44 mm Hg, diffuse corneal edema, and fibrin strands in the anterior chamber. TASS was diagnosed and topical steroids, cycloplegia, antiglaucoma drops, and oral acetazolamide were prescribed. At postoperative day 9, dispersed endothelial pigment with a fixed mid-dilated pupil were identified. Anterior segment optical coherence tomography showed strands of fibrin blocking the central ICL hole and angle closure. Pupillary block related to the fibrin occluding the AquaPORT hole consecutive to TASS was diagnosed. The patient underwent ICL removal, but had a persistent atonic, hyporeflexive pupil as a complication. CONCLUSIONS This case demonstrates that an AquaPORT hole may not be enough to prevent pupillary block in cases with postoperative intraocular inflammation, causing severe postoperative complications such as Urrets-Zavalia syndrome. Clinicians should consider this diagnosis in cases with corneal edema in the early postoperative period following AquaPORT ICL insertion. [J Refract Surg. 2020;36(12):856-859.].
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Toprak I, Cetin EN, Gunes CE, Martin-Seker C. Severe Intraocular Inflammation following Hydrophilic Acrylic Phakic Intraocular Lens Implantation in A Case with Concealed History of COVID-19: A Case Report and Literature Review. Ocul Immunol Inflamm 2021; 29:662-665. [PMID: 33793389 DOI: 10.1080/09273948.2021.1880602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To firstly present management of toxic anterior segment syndrome (TASS) and possible postoperative endophthalmitis (POE) after implantation of a new hydrophilic-acrylic posterior chamber (PC) phakic intraocular lens (pIOL) in a case with undeclared history of COVID-19.Methods: A 21-year-old male without known disease represented severe anterior chamber inflammation (hypopyon), poor vision and corneal edema without vitreous involvement (TASS) at 24-hours after PC-pIOL implantation for unilateral high myopia (amblyopic).Results: Preoperative best-corrected visual acuity (BCVA) was 0.2 OS (-13 diopters). At 56-hours, vitreous was involved with visual loss indicating POE. The patient confessed that he had COVID-19 1-month ago. COVID-19 immunoglobulin M/G tests were positive, while other markers were negative. Intracameral/intravitreal antibiotics were applied. BCVA was 0.15 without hypopyon at 24-hours. Cultures were negative. Final BCVA was 0.6 with normal examination.Conclusion: TASS/POE etiology could not be demonstrated in this case, whereas COVID-19-related proinflammatory systemic background could have effect on triggering/aggravating this scenario.].
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Affiliation(s)
- Ibrahim Toprak
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Kinikli, Turkey
| | - Ebru Nevin Cetin
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Kinikli, Turkey
| | - Celal Emre Gunes
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Kinikli, Turkey
| | - Cigdem Martin-Seker
- Department of Ophthalmology, Faculty of Medicine, Pamukkale University, Kinikli, Turkey
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Unilateral Toxic Anterior Segment Syndrome Resulting in Cataract and Urrets-Zavalia Syndrome after Sequential Uneventful Implantation of a Posterior Chamber Phakic Toric Intraocular Lens at Two Different Surgical Facilities: A Series of Unfortunate Events. Case Rep Ophthalmol Med 2020; 2020:1216578. [PMID: 33204556 PMCID: PMC7657676 DOI: 10.1155/2020/1216578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 09/14/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background Phakic Intraocular Lens (P-IOL) implantation is a safe, easy, predictable intervention designed to manage moderate to high refractive errors. Complications are relatively uncommon and include mainly cataract and intraocular pressure spikes. Toxic Anterior Segment Syndrome (TASS) is a rather unusual sterile anterior segment inflammation after uneventful intraocular surgery, extremely rarely reported after P-IOL implantation. Urrets-Zavalia Syndrome (UZS) is also very rarely described after P-IOL. To date, to the best of the authors' knowledge, no article has ever described the simultaneous occurrence of TASS and UZS in a patient after P-IOL implantation. Objective In this article, the authors present the case of a female patient with moderate myopic astigmatism, who underwent sequential P-IOL implantation at two different facilities. The postoperative course of the first eye was uneventful, but she developed complications associated to the intervention in the second eye. Materials The article describes the case of a young patient who underwent a sequential Phakic Intraocular Lens (P-IOL) implantation at two different institutions. The postoperative course of the first eye (left eye) was uneventful; however, the second eye (right eye) initially developed Toxic Anterior Segment Syndrome (TASS). Although timely and correct management was instituted, upon resolution of TASS, the patient developed Urrets-Zavalia Syndrome, anterior subcapsular cataract, and significant endothelial damage in the same eye. Results The patient was followed closely and managed accordingly; corneal edema and anterior segment inflammation of the right eye eventually resolved. Nevertheless, an anterior subcapsular cataract and a fixed dilated pupil remained; with normal intraocular pressure (IOP). Specular microscopy confirmed an endothelial cell loss in the TASS eye (right eye). Pupil size showed no reaction to repeated doses of Pilocarpine 2%. A month after surgery, refraction on her right eye was +0.25 + 0.75 × 93, which resulted in a 20/50 vision. Conclusions TASS and UZS are both extremely rare complications after uneventful P-IOL implantation, with only a handful of cases having been reported of each of them. To date, this is the very first case where UZS ensued after and potentially as a consequence of TASS in a patient who had undergone P-IOL implantation. Although a direct causative element could not be pinpointed, the fact that the complication ensued after being operated in one surgical institution and not the other, could suggest some role of different sterilization and handling procedures, but no direct conclusion can be made on this case.
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Shouchane-Blum K, Gershoni A, Mimouni M, Zahavi A, Segal O, Geffen N. The association between toxic anterior segment syndrome and intraocular pressure. Graefes Arch Clin Exp Ophthalmol 2020; 259:425-430. [DOI: 10.1007/s00417-020-04881-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 11/29/2022] Open
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Diffuse lamellar keratitis associated with tabletop autoclave biofilms: case series and review. J Cataract Refract Surg 2020; 46:340-349. [DOI: 10.1097/j.jcrs.0000000000000070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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