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Toxic anterior segment syndrome after uncomplicated cataract surgery possibly associated with intracamaral use of cefuroxime

Authors Cakir B, Celik E, Aksoy N, Bursali O, Uçak T, Bozkurt E, Alagoz G

Received 13 September 2014

Accepted for publication 21 November 2014

Published 17 March 2015 Volume 2015:9 Pages 493—497


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Burçin Çakir, Erkan Celik, Nilgün Özkan Aksoy, Özlem Bursali, Turgay Uçak, Erdinç Bozkurt, Gursoy Alagoz

Sakarya University Education and Research Hospital, Sakarya, Turkey

Purpose: To report toxic anterior segment syndrome (TASS) after cataract surgery possibly associated with intracameral use of cefuroxime.
Methods: We conducted a retrospective chart review and analysis on the pre- and postoperative conditions of the subjects who had developed TASS.
Results: The patient group consisted of 17 patients. Tyndallization and fibrin fibers were positive in all eyes. In four eyes, hypopyon formation developed. These reactions diminished on the third day and fully resolved 1 week after the operations with the use of intensive topical steroid and mydriatic therapy. To determine the etiology of TASS, infusion fluid, viscoelastics, and intracameral antibiotic agent were changed respectively. After changing intracameral antibiotic agent from cefuroxime axetile to moxifloxacin no new cases of TASS were diagnosed.
Conclusion: All agents injected into the anterior chamber can cause TASS. Ophthalmologists and operating room staff need to pay careful attention to all drugs and irrigating solutions.

Keywords: phacoemulsification, fibrin reaction, drug toxicity

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