Skip to main content

Table 1 Summary of 15 recent case reports of toxic anterior segment syndrome

From: Toxic anterior segment syndrome-an updated review

First Author (ref. no.)

Number of cases

Onset (days after the surgery)

Inciting agents

Clinical presentations

Managements (n)

Visual outcomes (n)

Miyake et al. [19]

6

42–167

IOL (ISert model 251, Hoya)

Chemosis,

Ciliary injection,

Decreased BCVA,

Corneal edema,

Anterior chamber reaction,

hypopyon

Vitretomy and IOL removal (1),

Capsule irrigation (2),

Medical treatment only (5)

BCVA 20/100 (1),

BCVA ≥20/30 (5)

Suzuki et al. [18]

251

38.44 ± 32.29 Range:0–161

IOL (ISert model 251 and 255, Hoya)

Anterior chamber reaction (99.2%), conjunctival injection (41.4%)

Hypopyon (22.7%)

Corneal edema (19.1%)

Keratic precipitates (27.9%)

Medical treatment only (142),

Surgical intervention:

vitrectomy (49), IOL removal (22), chamber irrigation (51)

BCVA

0.036 ± 0.242 logMAR

Sorenson et al. [10]

10

1–7

Bacterial biofilm contamination of autoclave reservoir

Anterior chamber reaction (10),

Hypopyon (3),

Corneal edema (1),

Anterior vitreous reaction (4)

Medical treatment only (3),

Vitreous tap and intravitreal injection (7)

No light perception (1),

BCVA≥20/30 (9)

Ohika et al. [8]

147

13.1 ± 16.4 Range: 1–88

IOL (Acrysof, Alcon)

Anterior chamber reaction (97.2%),

Conjunctival injection (39.8%), Fibrinous inflammation (43.1%)

Hypopyon (22.7%)

Corneal edema (15.6%)

Keratic precipitates (21.6%),

Ocular pain (9.5%)

Medical treatment only (104),

Surgical intervention:

vitrectomy (21), IOL removal (10), chamber irrigation (33)

BCVA> 20/40 (143),

BCVA≤20/40 (4)

Moyle et al. [9]

11

1

unknown

Corneal edema (11), anterior chamber reaction (10),

Inflammatory plaque on IOL (5), hypopyon (3), fibrin reaction (6), mild pain (2)

Medical treatment only (11)

BCVA = 20/20 (11)

Sengupta et al. [7]

60

1

Balanced salt solution with a low pH of 6.0 (12), OVD (17), unknown (31)

Severe iridocyclitis with varying degree of corneal edema (60)

Medical treatment only (56),

Vitreous tap (4)

BCVA: 0.11 ± 0.1 logMAR, range: 0–0.3 logMAR

Matsou et al. [36]

5

1

Generic trypan blue

Painless blurry vision, corneal edema, anterior chamber reaction, hypopyon and fibrin reaction

Medical treatment only (5)

BCVA: 0.82 ± 0.18 (Snellen acuity)

Bielory et al. [14]

2

1

intracameral lidocaine HCl 1% and phenylephrine 2.5% inadvertently preserved with 10% benzalkonium chloride.

Acute corneal decompensation (3)

Medical treatment only (1),

Corneal transplantation for decompensated cornea (2)

BCVA = 20/20 (1),

NA (1)

Althomali [38]

15

1–2

OVD

Corneal edema (15),

hypopyon (8)

Medical treatment only

BCVA: count finger (2) (other retina pathology),

BCVA: 20/70 (2),

BCVA≥20/50 (11)

Koban et al. [16]

1

1

Inadvertent overdose of intracameral gentamicin

Hyphema, corneal edema, chemosis, hemorrhagic fibrinous reaction,

Corneal decompensation

Penetrating keratoplasty after medical treatment

BCVA: 20/60

Cetinkaya et al. [54]

5

1

unknown

corneal edema (5), anterior chamber reaction (5), fibrin (3), hypopyon (3), increased intraocular pressure (3)

Penetrating keratoplasty (2)

BCVA: 20/100 (1),

BCVA: 20/40 (1),

BCVA≥20/30 (3)

Ari et al. [27]

19 (pediatric patients)

1–2

Ethylene oxide gas sterilization

Corneal edema, anterior chamber reaction,

Medical treatment only (18),

Penetrating keratoplasty (1)

NA

Buzard et al. [15]

2

1

Generic trypan blue

Cornea edema, anterior chamber reaction, hypopyon

Penetrating keratoplasty (2)

NA

Maier et al. [5]

24

1–2

Contamination of corneal trephine

Graft infiltration, corneal stromal edema

Medical treatment only (24)

NA

Choi et al. [28]

15

NA

Ethylene oxide gas sterilization

Corneal edema, anterior chamber reaction, conjunctival injection, pupil irregularity, fibrin reaction

Penetrating keratoplasty (5)

BCVA≥20/200 (14),

Light perception (1),

  1. IOL intraocular lens, BCVA best corrected visual acuity, NA not available, n case number