Ganesan Niruban, Srinivasan Renuka, Kaliaperumal Subashini
Department of Ophthalmology, JIPMER, Karaikal, Tamil Nadu, India.
Department of Ophthalmology, Pondicherry Institute of Medical Sciences, Puducherry, Tamil Nadu, India.
Oman J Ophthalmol. 2022 Dec 26;16(1):39-44. doi: 10.4103/ojo.ojo_352_21. eCollection 2023 Jan-Apr.
The purpose of the study was to analyze the outcomes of patients with toxic anterior segment syndrome (TASS) and Urrets-Zavalia (UZ) syndrome.
The records of all patients with TASS and UZ syndrome were studied. Corrected distance visual acuity (CDVA), intraocular pressure (IOP), and the details of surgeries performed were recorded at 1 and 3 months. We studied the changes in CDVA and IOP using repeated-measure ANOVA and paired t -test, respectively.
Four patients (44.4%) developed refractory UZ syndrome, and five (55.6%) patients had TASS. At the end of 3 months of follow-up, all nine patients had concentric rings of iris atrophy and corneal edema. None of the cases had hypopyon or vitritis. Peripheral anterior synechiae (PAS) with secondary glaucoma was present only in cases of UZ syndrome. Among the four cases of UZ syndrome, goniosynechialysis was performed for 2 cases and trabeculectomy for one case. Despite these interventions, IOP could not be controlled. Patients in the TASS group did not exhibit PAS formation, and IOP was normal, but corneal edema and concentric rings of iris atrophy persisted. Descemet's stripping endothelial keratoplasty was performed for all the TASS cases. There was a statistically significant drop in CDVA ( = 0.028) and an increase in IOP ( = 0.029) at 3-month postcataract surgery.
TASS and UZ syndrome could result in sight-threatening complications. They may be considered diseases of the same entity as both the conditions were found in the same cluster. TASS could be considered as an abortive attack of UZ syndrome.
本研究旨在分析毒性眼前节综合征（TASS）和乌雷茨 - 萨瓦利亚（UZ）综合征患者的治疗结果。
研究所有TASS和UZ综合征患者的病历。在术后1个月和3个月记录矫正远视力（CDVA）、眼压（IOP）以及所施行手术的详细情况。我们分别使用重复测量方差分析和配对t检验研究CDVA和IOP的变化。
4例患者（44.4%）发生难治性UZ综合征，5例（55.6%）患者发生TASS。随访3个月末，所有9例患者均出现虹膜萎缩同心环和角膜水肿。所有病例均无前房积脓或玻璃体炎。周边前粘连（PAS）伴继发性青光眼仅见于UZ综合征病例。在4例UZ综合征病例中，2例行前房角分离术，1例行小梁切除术。尽管采取了这些干预措施，眼压仍无法控制。TASS组患者未出现PAS形成，眼压正常，但角膜水肿和虹膜萎缩同心环持续存在。所有TASS病例均行后弹力层剥除内皮角膜移植术。白内障手术后3个月，CDVA有统计学意义的下降（P = 0.028），眼压升高（P = 0.029）。
TASS和UZ综合征可导致威胁视力的并发症。它们可能被视为同一类疾病，因为这两种情况在同一组中被发现。TASS可被视为UZ综合征的一次未遂发作。
