Refractive Surgery Center, Wuhan Aier Ophthalmology Hospital, No.481, Zhongshan Road, Wuhan, Hubei, China.
BMC Ophthalmol. 2024 Aug 15;24(1):347. doi: 10.1186/s12886-024-03615-2.
Toxic anterior segment syndrome (TASS) is a rare, noninfectious inflammation that occurs after anterior segment surgery. We report a case herein that developed presumed atypical late-onset TASS after V4c implantable collamer lens (ICL) implantation surgery.
A 26-year-old man underwent ICL implantation surgeries of both eyes on two separate days. The 1-day and 7-day postoperative routine follow-up visits revealed no abnormalities. However, one month after surgery, dense white spots attached to the posterior surface and scattered ones to the anterior surface of ICL in the left eye were noted on anterior segment examination. His uncorrected distance visual acuity (UDVA) was 20/16 in both eyes and the fundus examination was normal. Despite the absence of typical clinical manifestations, late-onset TASS was suspect and intense topical steroid was administered. After 6 weeks of tapering topical steroid therapy, the white spots disappeared and the patient had no subjective complains throughout the treatment period.
This case suggested that the traditionally considered acute and serious TASS could also present as delayed and insidious onset after ICL implantation surgery. Due to its variabilities, the awareness of TASS should be raised to ophthalmologists and regular follow-up visits should be emphasized to patients. Once TASS was suspected, intensive steroid therapy should be implemented in time.
毒性前节综合征（TASS）是一种罕见的非感染性炎症，发生在前节手术后。我们报告了一例在 V4c 可植入 Collamer 透镜（ICL）植入手术后发生疑似非典型迟发性 TASS 的病例。
一名 26 岁男性，分两天进行了双眼 ICL 植入手术。术后 1 天和 7 天的常规随访检查未见异常。然而，术后 1 个月，左眼 ICL 的后表面附着密集的白色斑点，前表面散布着一些白色斑点。他的未矫正远视力（UDVA）双眼均为 20/16，眼底检查正常。尽管没有典型的临床表现，但怀疑为迟发性 TASS，并给予了强烈的局部类固醇治疗。经过 6 周的局部类固醇减量治疗后，白色斑点消失，患者在整个治疗期间没有任何主观不适。
本病例提示，传统上认为的急性和严重的 TASS 在 ICL 植入手术后也可能表现为延迟和隐匿性发作。由于其变异性，眼科医生应提高对 TASS 的认识，并强调对患者进行定期随访。一旦怀疑 TASS，应及时进行强化类固醇治疗。
