Suzuki Takashi, Ohashi Yuichi, Oshika Tetsuro, Goto Hiroshi, Hirakata Akito, Fukushita Kimiko, Miyata Kazunori
Department of Ophthalmology, Ehime University, Graduate School of Medicine, Ehime, Japan.
Department of Ophthalmology, Ehime University, Graduate School of Medicine, Ehime, Japan.
Am J Ophthalmol. 2015 May;159(5):934-9.e2. doi: 10.1016/j.ajo.2015.01.023. Epub 2015 Jan 28.
To describe clinical findings associated with an outbreak of toxic anterior segment syndrome (TASS) after implantation of 1-piece intraocular lenses (IOLs; HOYA iSert(®) 251 and 255; HOYA Co Ltd, Tokyo, Japan) contaminated with aluminum.
Multicenter observational retrospective case series.
Cases developing TASS after IOL implantation from November 2011 to February 2013 were reported to the HOYA IOL-Related Endophthalmitis Investigation Committee. Infectious endophthalmitis was excluded. Data were collected on patient backgrounds, the time from IOL implantation to development of the first symptoms, clinical findings, treatment, and best-corrected visual acuity (BCVA) scores before and after treatment. BCVA data were converted into logMAR figures to allow for statistical analysis.
We identified 251 cases of late-onset TASS in patients of mean age 72.85 years treated in 183 hospitals. Common clinical features included the presence of anterior chamber cells (99.2%), conjunctival injection (41.4%), fibrinous inflammation (26.7%), and hypopyon (22.7%). Mean BCVA at the onset of ocular inflammation was 0.253 ± 0.424. The mean time from IOL implantation to development of the first symptoms was 38.44 ± 32.29 days. Of all eyes, 142 were treated with steroids and antibiotics, and 109 underwent surgery, including washing of the anterior chamber, removal of the IOL, and vitrectomy. Mean BCVA after treatment was 0.036 ± 0.242, significantly better than at the onset of ocular inflammation (P < .05).
This is the first report of an outbreak of late-onset TASS after implantation of a particular type of IOL.
描述植入受铝污染的单片式人工晶状体（IOL；HOYA iSert® 251和255；日本东京HOYA株式会社）后发生的中毒性眼前段综合征（TASS）暴发相关的临床发现。
多中心观察性回顾性病例系列研究。
2011年11月至2013年2月期间植入IOL后发生TASS的病例报告给HOYA人工晶状体相关眼内炎调查委员会。排除感染性眼内炎。收集患者背景、从IOL植入到出现首个症状的时间、临床发现、治疗情况以及治疗前后的最佳矫正视力（BCVA）评分等数据。将BCVA数据转换为logMAR值以便进行统计分析。
我们在183家医院治疗的平均年龄为72.85岁的患者中确定了251例迟发性TASS病例。常见临床特征包括前房细胞（99.2%）、结膜充血（41.4%）、纤维素性炎症（26.7%）和前房积脓（22.7%）。眼部炎症发作时的平均BCVA为0.253±0.424。从IOL植入到出现首个症状的平均时间为38.44±32.29天。所有眼中，142只接受了类固醇和抗生素治疗，109只接受了手术，包括前房冲洗、IOL取出和玻璃体切除术。治疗后的平均BCVA为0.036±0.242，明显优于眼部炎症发作时（P<.05）。
这是关于植入特定类型IOL后发生迟发性TASS暴发的首份报告。
