A case of Toxic Anterior Segment Syndrome after Cataract Surgery

1
A case of Toxic Anterior Segment Syndrome after
Cataract Surgery
Sung Kun Chung M.D. Mee Yon Lee M.D. Jin A
Choi M.D. Eun Jung Jun M.D. Department of
Ophthalmology and Visual Science The Catholic
University of Korea
Min Kim M.D. Seung Hee Lee M.D. Department of
Ophthalmology Seoul Adventist Hospital

• No author has any financial or proprietary
  interest in any materials or methods mentioned

2
CASE

• 78-year old female patient had uneventful
• phacoemulsification via clear corneal
• incision with no suture and implantation
• of the acrylic intraocular lens.

3
Toxic anterior segment syndrome
Sterile postoperative inflammatory reaction
caused by a noninfectious substance that enters
the anterior segment resulting in toxic damage
to intraocular tissues
Starts 12 to 48 hours after anterior segment
surgery and usually limited to the anterior
segment of the eye. Gram stain and culture are
negative. The symptom improves with steroid
treatment.
4
CASE

• Post operative 1st day
• Ocular finding was
• diffuse corneal edema
• Descemet membrane folding and
• anterior chamber inflammation

5
CASE
Post operative 3rd day
Post operative 7th day
Anterior chamber reaction was decreased but
cornea edema was progressed during
observation. Our impression was
Toxic anterior segment syndrome.
6

• 4 cases showed same symptoms of
• toxic anterior segment syndrome.
• We found that the cases used same
• surgical instruments and tubing soaked in
• same antiseptic solution.(CIDEXOPA Jhonson
  Jhonson U.S.A.)
• This solution was used after
• cataract surgery in the case of
• HBsAg()
  VDRL().

7
CONCLUSIONS

• Toxic anterior segment syndrome
• all the possible causes
  should
• be evaluated so that the same syndrome
• may not occur.