Toxic anterior segment syndrome (TASS) is a very serious eye problem. Though it is very rare, it can follow intraocular surgery. There are many reasons for its seriousness such as cystoid macular edema, atrophy of the iris, nerve damage in optic, capsular opacification and other conditions.
TASS is caused by a non-infectious agent that penetrates into the anterior segment, causing toxic damage to intraocular tissues. Often TASS occurs following a cataract surgery. Post operative complications followed by intraocular lens implantation are also reported by some ophthalmologists.
One should always keep in mind that TASS is a post operative condition inflammating the anterior segment, yet caused by a non- infectious substance.
Ophthalmologists are worried about patients developing blurred vision, optic nerve damage and severe inflammation after an intraocular tissue damage. A layer of WBC could be developed around the anterior chamber which is known as hypopyon formation. Redness in the conjunctiva and sclera is also seen in patients suffering from TASS.
Symptoms such as redness, inflammation and blurred vision are seen within 48 hours of surgery even though they don’t feel any pain in their eyes. Sensitivity to light and brightness are expected. The main symptoms are felt post 12 hrs after surgery and after a week infectious endophthalmitis is expected to develop.
TASS may be caused by anesthetics, ointments and even at sterilization stage. It may be even caused from enzymes and detergents. The literal cause of TASS may shock you. Millions of surgeries are performed all over the world but the time taken to sterilize the instruments has decreased as there is less time for preparation between surgeries, thus lacking in preparation.
Surgeons must be careful always that all the operating instruments are sterilized and ensure that there are no leftover enzymes and detergents, which can develop anterior segment infections. Also make sure that autoclave and ultrasound devices are neat and clean. Unclean devices may spread gram negative bacteria and endotoxin contamination. Even some intraocular irrigation solutions with unusual ph levels can cause toxic anterior segment syndrome.