Wydanie 3/2010
str. 77

Zespół toksycznego uszkodzenia przedniego odcinka oka

Toxic Anterior Segment Syndrome

Ewa Mrukwa-Kominek1,2, Daniela Ferda2, Adam Cywiński2

1 Klinika Okulistyki Katedry Okulistyki Śląskiego Uniwersytetu Medycznego w Katowicach
2 Samodzielny Publiczny Szpital Kliniczny Śląskiego Uniwersytetu Medycznego w Katowicach
  Kierownik: prof. dr hab. n. med. Wanda Romaniuk

Summary: Toxic Anterior Segment Syndrome (TASS) is an acute postoperative inflammatory reaction caused by a noninfectious substance that enters the anterior segment and induces toxic damage to the intraocular tissues. Cellular necrosis and/or apoptosis and extracellular damage occur, resulting in a severe acute inflammatory immune response. The hallmark of TASS is its rapid onset, usually 12-24 hours after anterior segment surgery. Nearly all cases occurred after uneventful cataract surgery. Patients complain of blurry vision, eye redness, they are usually pain free. TASS almost always is limited to anterior segment. Features that are unique to TASS are: diffuse “limbus to limbus” corneal oedema, an unreactive dilated pupil, increase intraocular pressure secondary to trabecular meshwork damage, the absence of vitritis, cystoid macular oedema. Infectious endophtalmitis can be differentiated by later presentation, pain and vitritis. Patients with TASS often respond rapidly to treatment with intense topical corticosteroids. Multiple causes and associations have been implicated with TASS (e.g. irrigating solutions, ophthalmic viscoelastic devices, preservatives, ophthalmic instrument contaminants, IOLs and ocular medication). Prognosis depends on the concentration of what material was caused this as well as how much of it go into eye and how soon treatment was initiated.

Słowa kluczowe: zespół toksycznego uszkodzenia przedniego odcinka oka, zespół toksycznego uszkodzenia śródbłonka rogówki, chirurgia zaćmy, zapalenie wnętrza gałki ocznej, zapalenie odcinka przedniego błony naczyniowej.

Keywords: Toxic Anterior Segment Syndrome, Toxic Endothelial Cell Destruction Syndrome, cataract surgery, endophthalmitis, non-infectious iridocyclitis.