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بسم الله الرحمن الرحيم

بسم الله الرحمن الرحيم. DR ALI SALEHI. TOXIC ANTERIOR SEGMENT SYNDROM (TASS). TASS. Sterile postoperative inflammatory reaction caused by a noninfectious substance that enters the anterior segment resulting in toxic damage to intraocular tissues. (mason et al in1992). TASS. The

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بسم الله الرحمن الرحيم

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  1. بسم الله الرحمن الرحيم • DR ALI SALEHI

  2. TOXIC ANTERIOR SEGMENT SYNDROM(TASS)

  3. TASS • Sterile postoperative inflammatory reaction caused by a noninfectious substance that enters the anterior segment resulting in toxic damage to intraocular tissues. (mason et al in1992)

  4. TASS • The pathologic changes are limited to the anterior chamber.

  5. TASS • is an acuteinflammation of anterior segment of the eye following cataract surgery. • A variety of substances have been implicated as causes of TASS.

  6. Extraocular substances a) Topical anti-septic agents b) Talc from surgical gloves c) Topical ophthalmic ointment 2) Products that are introduced into the anterior chamber as a part of the surgical procedure a) Anesthetic agents b) Preservatives c) IOL d) drugs

  7. TASS • The symptoms and signs • of TASS may mimic those of infectious endophthalmitis and include: • pain, • photophobia, • severe reduction in visual acuity, • marked anterior chamber reaction occasionally with • hypopyon.

  8. TASS presents within 12-24 hours • whereas acute • infectiousendophthalmitis typically develops 2-7 days after surgery.

  9. TASS • Other potentially • distinguishing features of TASS include • diffuse, limbus-to-limbus corneal edema; • anterior chamber opacification 3) a dilated, irregular or nonreactive pupil 4) and elevated lOP.

  10. TASS • Skin cleansers containing • chlorhexidine gluconate (eg, Hibiclens) have been reported to cause irreversible corneal edema • and opacification if they come into contact with the endothelial surface.

  11. TASS • Preservatives present in prediluted epinephrine (I: I0,000) added to irrigating solutions have been implicated in corneal decompensation. Unpreserved I: 1000 epinephrine is preferred. . Substitution of sterile water for balanced salt solution,

  12. Treatment • consists of intensive topical corticosteroids until the inflammation subsides. • A brief course of systemic corticosteroids may be beneficial. • Frequent • follow-up is necessary to monitor lOP and to reassess for signs of bacterial infection.

  13. Infectious endophthalmitis caused by bacteria and fungi is often difficult to distinguish • from other types of intraocular inflammation.

  14. TASS • Excessive inflammation without endophthalmitis is often encountered postoperatively in the setting of • complicated surgery, preexisting uveitis • keratitis, • diabetes, • glaucoma therapy, and • previous surgery

  15. TASS • The most helpful distinguishing characteristic of true infectious endophthalmitis is • that the vitritis is progressive and out of proportion to other anterior segment findings. • When in doubt, the clinician should manage the condition as an infectious process

  16. THE END

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