Toxic anterior segment syndrome following phakic posterior chamber IOL: a rarity

Implantable collamer lenses (ICL) have gained popularity for correction of myopia where kerato-refractive procedures are not indicated as in cases of high myopic refractive errors. Toxic anterior segment syndrome (TASS) is a very uncommonly reported postoperative complication following ICL implantat...

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Bibliographic Details
Published in:BMJ case reports 2018-12, Vol.11 (1), p.bcr-2018-225806
Main Authors: Singh, Archita, Gupta, Noopur, Kumar, Vinod, Tandon, Radhika
Format: Article
Language:English
Subjects:
Adult
Anterior Eye Segment
Case reports
Cataracts
Data collection
Diagnosis, Differential
Edema
Endophthalmitis - diagnosis
Endophthalmitis - diagnostic imaging
Endophthalmitis - drug therapy
Female
Fluprednisolone - administration & dosage
Fluprednisolone - analogs & derivatives
Fluprednisolone - therapeutic use
Glucocorticoids - administration & dosage
Glucocorticoids - therapeutic use
Humans
Inflammation
Lens Implantation, Intraocular - adverse effects
Myopia - surgery
Ophthalmic Solutions - administration & dosage
Ophthalmic Solutions - therapeutic use
Phakic Intraocular Lenses - adverse effects
Postoperative Complications
Surgery
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
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Summary:Implantable collamer lenses (ICL) have gained popularity for correction of myopia where kerato-refractive procedures are not indicated as in cases of high myopic refractive errors. Toxic anterior segment syndrome (TASS) is a very uncommonly reported postoperative complication following ICL implantation. A young patient developed severe corneal oedema and anterior segment inflammation on the first day after ICL implantation. Analysing retrospectively, possible idiosyncratic response to intracameral pilocarpine was considered as a cause for TASS. Prompt and intensive therapy with oral and topical potent steroids was visually rewarding. TASS, though a sterile inflammation can have catastrophic sequelae such as corneal decompensation and secondary glaucoma. Hence, timely identification and management is important.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2018-225806