TJ-CEO
2018 , Vol 13 , Num 3
Toxic Anterior Segment Syndrome: Is it Possible to Have Corneal Dysfunction Without Changes in Corneal Morphology?
1Uz. Dr., Asya Göz Tıp Merkezi, Katarakt ve Refraktif Cerrahi, İstanbul, Türkiye2Doç. Dr., Selçuk Üniversitesi Tıp Fakültesi, Göz Hastalıkları Anabilim Dalı, Konya, Türkiye Toxic anterior segment syndrome (TASS) is a sterile postoperative infl ammatory reaction caused by a noninfectious substance that enters the anterior segment, resulting in a wide range of toxic damage to intraocular tissues. The process typically begins 12 to 48 hours after anterior-segment surgery, but delayed mild cases have been reported. In this paper, a case of mild late-onset TASS that specifi cally caused corneal edema without changes in corneal morphology is described. While, ideally, corneal morphology should be documented by a corneal confocal microscopy, this case could be documented by a biomicroscopic anterior and posterior segment examination, central corneal thickness (CCT) detection by a corneal B mode ultrasound and a corneal specular microscope without corneal confocal microscopy. For this case, mild corneal edema was observed on postoperative day 32 (the CCT was 701 ?m on postoperative day 32, 602 ?m on postoperative day 75) without any specular microscopic changes (the preoperative endothelial cell density was 2660 cells/ mm2, and on postoperative day 75, it was 2660 cells/mm2) and major infl ammation in the anterior and posterior segment of the eye, which responded well and promptly to topical steroid treatment. The aim is to contribute to the identifi cation and proper management of similar patients and to discuss whether TASS causes corneal dysfunction without changes in corneal morphology, as the early detection of mild cases is important in preventing potentially severe cases. Keywords : Toxic anterior segment syndrome, corneal edema, cataract surgery complications