Toxic Anterior Segment Syndrome (TASS) Follow-up

Updated: May 03, 2017
  • Author: Jean Deschênes, MD, FRCSC; Chief Editor: Hampton Roy, Sr, MD  more...
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Follow-up

Further Outpatient Care

Initially, patients with toxic anterior segment syndrome (TASS) should be examined on a daily basis to assess their response to treatment.

Once the inflammation is resolved, patients need to be assessed carefully for corneal and/or trabecular meshwork damage.

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Deterrence/Prevention

All preoperative, intraoperative, and postoperative steps at the surgical center should be thoroughly assessed, including the following:

  • Surgical equipment and instruments
  • Sterilization process
  • Preoperative, intraoperative, and postoperative medications
  • Ultrasound water
  • Irrigating solutions
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Complications

Depending on the type of toxin, duration of exposure, and response to treatment, the following complications may result:

  • Corneal endothelial cell loss with resultant edema
  • Trabecular meshwork damage causing glaucoma
  • Iris sphincter muscle damage with resultant permanent dilated pupil
  • Cystoid macular edema
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Prognosis

Prognosis is generally divided into 3 groups depending on the severity of TASS.

A mild presentation of TASS will result in rapid clearing of the corneal edema with no long-term corneal or trabecular damage and normal or near normal visual acuity.

A moderate presentation of TASS will result in a persistent corneal edema that will take several weeks to clear, intraocular pressure that is difficult to control, and a moderate effect on visual acuity.

A severe presentation of TASS will result in a marked corneal edema that does not clear, iris and trabecular meshwork damage with resultant glaucoma, and possible cystoid macular edema. Visual outcome is usually poor despite medical or surgical intervention. A potential sequel manifestation of TASS is Urrets-Zavalia syndrome (UZS). [4]

Despite the above descriptions, predicting the outcome for patients remains difficult because of the multiple etiologies and associations linked to TASS.

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Patient Education

Patients should be instructed to immediately report any pain and/or a decline in visual acuity postoperatively. The sooner that TASS can be detected and treated, the better the outcome will be for the patients.

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