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Ginger-Eke H, Ogbonnaya C, Odayappan A, Shiweobi J. Toxic anterior segment syndrome following trabeculectomy with mitomycin C. GMS Ophthalmol Cases 2023; 13:Doc17. [PMID: 37850220 PMCID: PMC10577659 DOI: 10.3205/oc000225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Objective Toxic anterior segment (TASS) is a rare acute sterile anterior segment inflammation that typically develops within 12 to 24 hours after an anterior segment surgery. The purpose of this case report is to alert surgeons to the possibility of this complication following any anterior segment surgery, including trabeculectomy, and to highlight the possible etiologies and measures to prevent it. Patient and method A 58-year-old male glaucoma patient was initially managed medically for primary open angle glaucoma with antiglaucoma medications. There was rapidly progressive glaucomatous optic nerve damage in his left eye within the following year, despite the use of antiglaucoma medications, hence the need for trabeculectomy. Result The post-operative condition of the patient's eye was stormy with diffuse limbus-to-limbus corneal edema and profound Descemet's membrane folds, among other features of TASS, with associated deteriorating visual acuity. Conclusion Although there is no documented report of TASS following trabeculectomy with mitomycin C, surgeons should be alerted to this possibility. Preventive measures include extreme care to avoid errors while preparing and administering diluted solutions, especially medications that are administered into the intracameral space.
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Affiliation(s)
- Helen Ginger-Eke
- Department of Ophthalmology, Ebonyi State University, Abakaliki, Nigeria
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | - Chimdia Ogbonnaya
- Department of Ophthalmology, Ebonyi State University, Abakaliki, Nigeria
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
| | | | - Jude Shiweobi
- Department of Ophthalmology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria
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Sato H, Miyata K, Yoshikawa K, Chiba S, Mizukami M. Structural validity of the Trunk Assessment Scale for Spinal Cord Injury ( TASS) with Rasch analysis for individuals with spinal cord disorders. J Spinal Cord Med 2023:1-9. [PMID: 37707373 DOI: 10.1080/10790268.2023.2256515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVE To confirm the structural validity of the Trunk Assessment Scale for Spinal Cord Injury (TASS). PARTICIPANTS AND METHODS We evaluated 104 Japanese individuals with a spinal cord injury (SCI) (age 63.5 ± 12.2 years; 64 with tetraplegia) with the TASS 1-3 times. We conducted a Rasch analysis to assess the TASS' unidimensionality, fit statistics, category probability curve, ceiling/floor effects, local independence, reliability, and difference item function (DIF). RESULTS The TASS was observed to be a unidimensional and highly reproducible scale of item difficulty hierarchy that sufficiently identifies the superiority of the examinee's ability. The TASS was easy for the participants of this study. One TASS item was a misfit based on the infit and outfit mean square; another item also showed a DIF contrast for age. Several items were found to require a synthesis or modification of the content. The TASS showed a floor effect, and most of the non-scorers were individuals with a complete SCI. CONCLUSION Our findings clarify the structural validity of the TASS, and our analyses revealed that the TASS includes an unfitness item and was less challenging for individuals with SCIs. The improvements suggested by these results provide important information for modifying the TASS to a more useful instrument.
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Affiliation(s)
- Hiroki Sato
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Japan
- Department of Rehabilitation, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Kazuhiro Miyata
- Department of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Kenichi Yoshikawa
- Department of Rehabilitation, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Shuhei Chiba
- Department of Rehabilitation, Iwate Rehabilitation Center, Shizukuishi, Japan
| | - Masafumi Mizukami
- Department of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Japan
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Sato H, Miyata K, Yoshikawa K, Chiba S, Ishimoto R, Mizukami M. Validity of the trunk assessment scale for spinal cord injury ( TASS) and the trunk control test in individuals with spinal cord injury. J Spinal Cord Med 2023:1-8. [PMID: 37534928 DOI: 10.1080/10790268.2023.2228583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The Trunk Assessment Scale for Spinal Cord Injury (TASS) and the Trunk Control Test for individuals with a Spinal Cord Injury (TCT-SCI) are highly reliable assessment tools for evaluating the trunk function of individuals with SCIs. However, the potential differences in the validity of these two scales are unclear. OBJECTIVES To evaluate the criterion validity of the TASS and the construct validity of the TASS and TCT-SCI. PARTICIPANTS AND METHODS We evaluated 30 individuals with SCIs (age 63.8 ± 10.7 yrs, 17 with tetraplegia). To evaluate criterion validity, we calculated Spearman's rho between the TASS and the gold standard (the TCT-SCI). To determine construct validity, we used the following hypothesis testing approaches: (i) calculating Spearman's rho between each scale and the upper and lower extremity motor scores (UEMS, LEMS), the Walking Index for SCI-II (WISCI-II), and the motor score of the Functional Independence Measure (mFIM); and (ii) determining the cut-off point for identifying ambulators with SCIs (≥ 3 points on item 12 of Spinal Cord Independent Measure III) by a receiver operating characteristics analysis. RESULTS A moderate correlation was confirmed between the TASS and the TCT-SCI (r = 0.68). Construct validity was supported by six of the eight prior hypotheses. The cut-off points for identifying ambulators with SCIs were 26 points (TASS) and 18 points (TCT-SCI). CONCLUSION Our results indicate that the contents of the TASS and the TCT-SCI might reflect the epidemiological characteristics of the populations in which they were developed.
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Affiliation(s)
- Hiroki Sato
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
- Department of Rehabilitation, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Kazuhiro Miyata
- Department of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
| | - Kenichi Yoshikawa
- Department of Rehabilitation, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Shuhei Chiba
- Department of Rehabilitation, Iwate Rehabilitation Center, Shizukuishi, Japan
| | - Ryu Ishimoto
- Department of Physical Medicine and Rehabilitation, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan
| | - Masafumi Mizukami
- Department of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ibaraki, Japan
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Sato H, Miyata K, Yoshikawa K, Chiba S, Mizukami M. Responsiveness and minimal clinically important differences of the Trunk Assessment Scale for Spinal Cord injury ( TASS). J Spinal Cord Med 2022:1-9. [PMID: 35776096 DOI: 10.1080/10790268.2022.2087138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To confirm the responsiveness and minimal clinically important differences (MCIDs) of the Trunk Assessment Scale for Spinal Cord Injury (TASS). PARTICIPANTS AND METHODS We evaluated 48 Japanese individuals with spinal cord injury (SCI) (age 64.1 ± 10.4 yrs, 28 with tetraplegia) admitted to two institutions at admission, at 1 month of hospitalization, and at discharge with the TASS, the Trunk Control Test in individuals with an SCI (TCT-SCI) motor score, the Functional Independence Measure motor score (mFIM), and the Global Rating of Change Scale (GRCS). We assessed the TASS responsiveness by determining the correlation coefficients for the changes in the TASS' and other assessments' scores. We calculated the MCIDs by five anchor-based methods. RESULTS The changes in the TASS and those in the other assessments were weakly correlated at 1 month and moderately correlated at discharge. The TASS MCIDs were observed at 1 month and at discharge. CONCLUSION Our findings confirmed that the change in TASS scores had weak-to-moderate correlations with the changes in the participants' upper- and lower-limb function and activities of daily living. Using the MCID for the TASS determined by anchor-based methods may lead to a better interpretation of changes in the trunk function of individuals with SCIs.
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Affiliation(s)
- Hiroki Sato
- Graduate School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Japan
- Department of Rehabilitation, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Japan
| | - Kenichi Yoshikawa
- Department of Rehabilitation, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Shuhei Chiba
- Department of Rehabilitation, Iwate Rehabilitation Center, Shizukuishi, Japan
| | - Masafumi Mizukami
- Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Ami, Japan
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Mohamed-Noriega K, Guerra-Lorenzo F, Mohamed-Noriega J, Villarreal-Mendez G, Morales-Wong F, Mohamed-Hamsho J. Reduced corneal endothelial cell density after toxic anterior segment syndrome ( TASS) caused by inadvertent intraocular ointment migration: A case report. Int J Surg Case Rep 2022; 94:107029. [PMID: 35405515 PMCID: PMC9006328 DOI: 10.1016/j.ijscr.2022.107029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/29/2022] [Accepted: 03/31/2022] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Toxic anterior segment syndrome (TASS) is an acute sterile inflammation of the anterior segment which may occur after surgery. This case presents endothelial cell density (ECD) loss due to months of TASS caused by intraocular migration of ocular ointment. The chronicity of this case and the clinical consequences are rare in the literature. CASE PRESENTATION A Colombian 71-year-old man developed TASS secondary to intraocular ointment migration after uneventful cataract surgery with phacoemulsification and intraocular lens placement in the capsular bag. The main complaint for the patient was a chronic red eye, no pain or visual disturbance were reported, rheumatologic diseases were discarded. It was documented the presence of intraocular ointment in the anterior chamber, over the iris and in the anterior chamber angle. The ECD was reduced secondary to TASS and the long-term presence of ointment moving in the anterior chamber, so it had to be removed. CLINICAL DISCUSSION It is important to avoid using ocular ointment after intraocular surgeries to avoid the risk of ointment migration into the anterior chamber. Intraocular ointments should be removed promptly to reduce ECD loss as documented in the present case report in which after ointment elimination ECD remains stable for 7 years. CONCLUSION Topical ointments should not be used after routine cataract surgery because of the risk of intraocular ointment migration and subsequent risk of developing TASS and reduced ECD.
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Affiliation(s)
- Karim Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, 64460, Mexico.
| | - Fernando Guerra-Lorenzo
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, 64460, Mexico
| | - Jibran Mohamed-Noriega
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, 64460, Mexico
| | - Gerardo Villarreal-Mendez
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, 64460, Mexico
| | - Fernando Morales-Wong
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, 64460, Mexico
| | - Jesús Mohamed-Hamsho
- Department of Ophthalmology, University Hospital and Faculty of Medicine, Autonomous University of Nuevo León (UANL), Monterrey, 64460, Mexico
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Abstract
Background Toxic anterior segment syndrome (TASS) can be a rare complication of anterior segment surgery. Here we reviewed the most recent advances in the understanding of TASS. Methods English articles related to TASS were retrieved from “PubMed” using the following keywords; “toxic anterior segment syndrome” or “TASS”. The authors of this paper reviewed all the retrieved literature and critical findings were summarized. Results The onset of TASS can vary from hours to months. The clinical manifestations are also variable. The causes of TASS are broad and continue to expand and could not be elucidated in over half of the reported cases. Prompt and thorough investigation to explore the causes of TASS is critical. Surgeons should be fully aware and updated regarding possible etiologies and make ceaseless efforts to prevent TASS. This effort begins with establishing TASS prevention protocols and regularly training surgical staff. Proper cleaning of surgical instruments is critical and should follow the guidelines set by The American Society of Cataract and Refractive Surgery TASS Task Force. When TASS occurs, sharing information with other ophthalmologists and reporting new causes is crucial for the prevention of outbreaks. Conclusions Anterior segment surgeons should be reminded that TASS is mostly preventable by the establishment of TASS prevention protocols, regular surgical staff training and thorough adherence to recommendations for cleaning and sterilizing intraocular surgical instruments.
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Affiliation(s)
- Choul Yong Park
- Department of Ophthalmology, Dongguk University, Ilsan Hospital, Goyang, South Korea
| | - Jimmy K Lee
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Roy S Chuck
- Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
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Galvis V, Berrospi RD, Tello A, Santaella G. Interface Fluid Syndrome (IFS) following Toxic Anterior Segment Syndrome ( TASS): not related to high intraocular pressure but to endothelial failure. Saudi J Ophthalmol 2018; 33:88-93. [PMID: 30930670 PMCID: PMC6424685 DOI: 10.1016/j.sjopt.2018.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/29/2018] [Indexed: 11/19/2022] Open
Abstract
We describe the case of a 52-year-old female with past history of LASIK, 21 years earlier, without Fuchs’ endothelial dystrophy, who underwent phacoemulsification and intraocular lens (IOL) implantation. During the early postoperative period severe corneal edema, anterior chamber cellularity and iris inflammation presented, accompanied by a clear space along the LASIK interface. Those findings were interpreted as part of a Toxic Anterior Segment Syndrome (TASS) and secondary interface fluid syndrome (IFS). When interface fluid was present, intraocular pressure (IOP) measured in the center of the cornea yielded very low values. In addition, applanation tonometry performed in the corneal periphery, as well as Schiotz tonometry and digital tonometry also indicated that the IOP was not high. Fluid in the interface persisted until a DMEK was carried out 11 months after the phacoemulsification surgery. Five days postoperatively the IFS resolved, confirmed by OCT imaging. The origin of IFS in this case was corneal edema secondary to endothelial cell dysfunction and it was not related to high IOP. This is the first reported case of IFS following TASS, the third case published of DMEK procedure used to solve endothelial failure-related IFS, and the case with the longest time of presentation after LASIK.
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Affiliation(s)
- Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
- Universidad Autónoma de Bucaramanga, Faculty of Health Sciences, Bucaramanga, Colombia
| | - Rubén D. Berrospi
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
| | - Alejandro Tello
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
- Fundación Oftalmológica de Santander FOSCAL, Floridablanca, Colombia
- Universidad Autónoma de Bucaramanga, Faculty of Health Sciences, Bucaramanga, Colombia
- Corresponding author at: Centro Oftalmológico Virgilio Galvis, Centro Médico Ardila Lulle, Module 7, Floor 3, El Bosque, Floridablanca, Santander, Colombia. Fax: +57 7 6392626.
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Kim DJ, Chuck RS, Lee JK, Park CY. Reversible opacification of hydrophobic acrylic intraocular lens- two cases report. BMC Ophthalmol 2017; 17:111. [PMID: 28666434 DOI: 10.1186/s12886-017-0509-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background The opacification of the intraocular lens (IOL) can cause significant visual deterioration. It is known that opacity of hydrophobic acrylic IOLs is rare. We report 2 cases of reversible optic opacification of hydrophobic acrylic intraocular lenses (Tecnis ZCB00, Abbott), observed within 2 months after uneventful cataract surgery. Case presentation Case 1: Uneventful cataract surgery was performed on the left eye of an 86-year-old diabetic man with chronic open-angle glaucoma. A hydrophobic acrylic intraocular lens (IOL; Tecnis ZCB00, Abbott, Lake Bluff, IL) was implanted in the bag. Eye drops containing 0.5% levofloxacin and 1.0% prednisolone were used after surgery along with topical anti-glaucoma medications. At 7 weeks postoperative, cloudy, concentric IOL opacification developed, accompanied by decreased visual acuity and increased intraocular pressure. However, the opacification completely disappeared after 9 weeks. Case 2: Uneventful cataract surgery was performed on the left eye of a 72-year-old woman. A hydrophobic acrylic IOL (Tecnis ZCB00) was implanted in the bag. At 2 weeks postoperative, cloudy, concentric IOL opacification developed, accompanied by ocular discomfort. After 4 weeks, opacification and discomfort completely disappeared. Conclusions We observed two cases of completely reversible opacification of hydrophobic acrylic IOLs. The exact nature of the transient opacity remains unclear, but an inflammatory origin cannot be completely ruled out.
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Abstract
Purpose To evaluate the clinical findings and courses of five patients who developed toxic anterior-segment syndrome (TASS) after cataract surgery and investigate the cause. Materials and methods In May 2010, on the same day, ten patients were operated on by the same surgeon. Five of these patients developed TASS postoperatively. Results Patients had blurred-vision complaints on the first day after the operation, but no pain. They had different degrees of diffuse corneal edema, anterior-chamber reaction, fibrin, hypopyon, iris atrophies, and dilated pupils. Their vision decreased significantly, and their intraocular pressures increased. Both anti-inflammatory and antiglaucomatous therapies were commenced. Corneal edema and inflammation resolved in three cases; however, penetrating keratoplasty was needed for two cases and additional trabeculectomy was needed for one case. Although full investigations were undertaken at all steps, we could not find the causative agent. Conclusion TASS is a preventable complication of anterior-segment surgery. Recognition of TASS, differentiating it from endophthalmitis, and starting treatment immediately is important. Controlling all steps in surgery, cleaning and sterilization of the instruments, and training nurses and other operation teams will help us in the prevention of TASS.
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Affiliation(s)
- Servet Cetinkaya
- Ophthalmology Clinics, Turkish Red Crescent Hospital, Konya, Turkey
| | - Zeynep Dadaci
- Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | | | - Nursen Oncel Acir
- Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, Turkey
| | | | - Ekrem Kadioglu
- Ophthalmology Clinics, Beyhekim State Hospital, Konya, Turkey
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