Cetinkaya Servet, Dadaci Zeynep, Aksoy Hüsamettin, Acir Nursen Oncel, Yener Halil Ibrahim, Kadioglu Ekrem
Ophthalmology Clinics, Turkish Red Crescent Hospital, Konya, Turkey.
Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya, Turkey.
Clin Ophthalmol. 2014 Oct 9;8:2065-9. doi: 10.2147/OPTH.S71541. eCollection 2014.
To evaluate the clinical findings and courses of five patients who developed toxic anterior-segment syndrome (TASS) after cataract surgery and investigate the cause.
In May 2010, on the same day, ten patients were operated on by the same surgeon. Five of these patients developed TASS postoperatively.
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.
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.
评估5例白内障手术后发生毒性眼前节综合征（TASS）患者的临床症状及病程，并探究其病因。
2010年5月，同一天，同一位外科医生为10例患者实施了手术。其中5例患者术后发生了TASS。
患者术后第一天出现视力模糊主诉，但无疼痛。他们有不同程度的弥漫性角膜水肿、前房反应、纤维蛋白、前房积脓、虹膜萎缩及瞳孔散大。视力显著下降，眼压升高。开始了抗炎及抗青光眼治疗。3例患者的角膜水肿和炎症消退；然而，2例患者需要行穿透性角膜移植术，1例患者需要额外行小梁切除术。尽管在各个环节都进行了全面调查，但我们未能找到致病因素。
TASS是眼前节手术可预防的并发症。认识TASS、将其与眼内炎相鉴别并立即开始治疗很重要。把控手术的各个环节、器械的清洁与消毒以及培训护士和其他手术团队将有助于预防TASS。
