Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
J Cataract Refract Surg. 2012 Nov;38(11):1902-10. doi: 10.1016/j.jcrs.2012.06.053. Epub 2012 Sep 19.
To determine how the most common risk factors for toxic anterior segment syndrome (TASS) have evolved over the past decade.
John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
Cross-sectional study.
This was a retrospective analysis of surveys from centers reporting cases of TASS from June 1, 2007, through March 1, 2012, and information from visits to afflicted sites between October 1, 2005, and December 31, 2011. Results from June 1, 2009, to March 1, 2012, were compared with those collected before June 1, 2009.
The data from 130 questionnaires and 71 site visits were analyzed. The reporting centers performed approximately 69 000 surgeries and reported 1454 cases of TASS. Several trends were noted when comparing the most recent data with previously reported results. There was a 26% reduction in sites reporting inadequate handpiece flushing volumes and a 27% increase in sites using a deionized/distilled final rinse. At sites visited, there was a 36% reduction in the use of preserved epinephrine and a 36% reduction in the use of enzymatic detergents. However, there was a 21% increase in handling of intraocular lenses or instrument tips with gloved hands, a 47% increase in poor instrument maintenance, and a 34% increase in ultrasound bath use without adequate routine cleaning.
Education may have improved some instrument-cleaning and perioperative practices that increase the risk for TASS; however, other practices may be headed in an unfavorable direction.
No author has a financial or proprietary interest in any material or method mentioned.
确定在过去十年中，导致前节毒性综合征（TASS）的最常见危险因素是如何演变的。
美国犹他州盐湖城犹他大学约翰 A. 莫兰眼科中心。
横断面研究。
这是对 2007 年 6 月 1 日至 2012 年 3 月 1 日期间报告 TASS 病例的中心的调查以及 2005 年 10 月 1 日至 2011 年 12 月 31 日期间到受影响部位就诊的信息进行的回顾性分析。将 2009 年 6 月 1 日至 2012 年 3 月 1 日的结果与 2009 年 6 月 1 日之前收集的数据进行比较。
分析了 130 份问卷和 71 次现场访问的数据。报告中心共进行了约 69000 例手术，报告了 1454 例 TASS。将最近的数据与之前报告的结果进行比较时，注意到了几个趋势。报告冲洗量不足的部位减少了 26%，使用去离子/蒸馏水最终冲洗的部位增加了 27%。在访问的部位，使用保存的肾上腺素的减少了 36%，使用酶清洁剂的减少了 36%。然而，戴手套处理眼内晶状体或器械尖端的增加了 21%，器械维护不善的增加了 47%，超声浴使用而不进行充分的常规清洁的增加了 34%。
教育可能改善了一些增加 TASS 风险的器械清洗和围手术期操作；然而，其他操作可能朝着不利的方向发展。
