Patients tend to respond very well to topical steroid treatment. Another of the very rare complications of cataract surgery, “Toxic Anterior Segment Syndrome” (TASS) surfaces between 12-72 hours after surgical treatment of cataracts. Recognition of TASS, differentiating it from endophthalmitis, and starting treatment immediately is important. In conclusion, TASS is a preventable complication of anterior-segment surgery.

Additional information is available from the National Institutes of Health, National Eye Institute, at In some cases it can lead to serious complications that could result in vision loss and require additional surgeries to treat.The FDA’s Center for Devices and Radiological health (CDRH) confirmed through studies that TASS was linked to medical devices for eye surgery. Both patients presented 24 hours after their uneventful operations with painless blurred vision in the operated eye. Flare and fibrin formation are other common findings in TASS (Figure 1).Damage to the iris following the toxic substance and inflammatory response can lead to an irregular or permanently dilated pupil.Involvement of the trabecular meshwork can also lead to secondary glaucoma, which may be difficult to control. Kim JH showed in three successive cases, that injection of denatured OVD leads to intraocular inflammation [6].There have been multiple reports of contaminated IOLs causing TASS. In severe cases TASS is an acute sterile anterior chamber inflammatory reaction that usually develops 12-48 hours after anterior segment surgery. Assistance also can be The frequency of instillation is determined by the severity of the inflammation. There have been cases of delayed presentation of TASS following implantation of a specific intraocular lens (ISert model 251) between 42 days and 137 days after implantation but the majority of TASS cases occur 12-48 hours after the operation, with the most common complaint being blurred vision [4].

The condition is responsive to topical steroids in most cases. There was no view of the posterior segment on biomicroscopy but B-scan did not show any evidence of posterior segment inflammation.An 82-year-old lady who was on the same theatre list as the above patient, also presented 24 hours after an uneventful cataract operation in her right eye. The patients included three women and one man with a median age of 68 years (range: 55--76 years). Toxic Anterior Syndrome (TASS) is a rare and devastating complication of intraocular surgery. The ophthalmologist was board certified, had been practicing for 20 years, and was the only ophthalmologist at the Investigation by the Intermountain Ocular Research Centre at the University of Utah, as well as investigators from the United States Centres for Disease Control (CDC) found that the vast majority of patients were exposed to one particular brand of BSS that was used during cataract surgery. Both aqueous and vitreous taps are sent for culture to investigate for an infectious process. Each day is hard to get through, blured vision, watery eyes, burning, headaches,red eyes and I look 15 yrs older, due to the way my eyes look. All four patients had TASS after surgery. years (range: 68--90 years). patients. Assistance with investigating outbreaks can Both patients have done well and four weeks after their presentation, there was a significant improvement in the anterior chamber reaction. October 12, the hospital's infection-control practitioner reported the cases to MDHHS, which began an investigation. EYE NEWS VOLUME 26 ISSUE 2 AUGUST/SEPTEMBER 2019 Figure 1: Limbus to limbus corneal oedema, anterior segment inflammation including hypopyon seen in a patient with TASS. The Canadian Ophthalmology society also has a TASS task force, which serves to investigate any outbreaks of TASS and offer guidance on appropriate prevention and management of the condition. a complication of anterior segment eye surgery; cataract extraction is the most common form of this type of surgery. SC068684) | © 2020 Acute onset of anterior chamber inflammation 12-48 hours after uneventful anterior segment surgery  The physician should note the time of onset after eye surgery in conjunction with the patient's symptoms. are used to maintain space within the eye during surgery. Furthermore, if the inflammation is not responding to steroid therapy, one has to re-consider the possibility of an infective cause and a vitreous tap or a repeat culture may be required.As mentioned above, delayed presentations of TASS may occur as a result of faulty or contaminated IOLs, as demonstrated by Oshika Surgical intervention may also be required in severe cases of TASS where there is persistent corneal oedema secondary to permanent endothelial damage [18]. While it is not always a condition that can be instigated, but it is better to be aware of the condition, just in case it is a complication that your body takes on.

surgery. While it is not always a condition that can be instigated, but it is better to be aware of the condition, just in case it is a complication that your body takes on. The patient should be followed closely and evaluated by a retina specialist to rule out infectious causes.

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