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- Similar to endophthalmitis, TASS cannot be prevented completely but the rate may be reduced.
- It is generally recommended to avoid the intraocular use of medications and solutions that contain benzalkonium chloride, thimerosal, eidetic acid, and sodium bisulfite (111).
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The use of routine intracameral antibiotics has become more common in many areas of the world, although this usage remains controversial. Most cases of TASS are successfully treated with topical steroids, non-steroidal anti-inflammatory drops, or both.If not resolved after 6 weeks, permanent damage is more likely to occur. Tissue damage can result in vision loss.
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Intraoperative factors include large-incision extracapsular cataract extraction, clear cornea incision, posterior capsule rupture with or without vitreous loss, and a less experienced surgeon (3,10-13). Some authors report the non-use of intracameral antibiotics as a risk factor, but the overall benefit of intracameral antibiotics remains controversial, especially in the US (14-16). Postoperative factors include early wound leak (17,18). Clinical diagnosis is made based on many factors. The physician should note the time of onset after eye surgery in conjunction with the patient’s symptoms. The anterior chamber should be examined carefully for anterior chamber reaction, intraocular pressure and severity of vision loss.
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Toxic Anterior Segment Syndrome (TASS) is a rare and devastating complication of intraocular surgery. TASS is an acute sterile anterior chamber inflammatory reaction that usually develops hours after anterior segment surgery. Late-onset TASS has also been reported. The condition is responsive to topical steroids in most cases. Risk factors for endophthalmitis include preoperative, intraoperative, and postoperative factors. Preoperative factors include uncontrolled blepharitis or other ocular surface disease, diabetes mellitus, an immunocompromised state, infectious foci near the surgical site, and advanced age (5,10-12).