Outbreak of toxic anterior segment syndrome associated with glutaraldehyde after cataract surgery.

Abstract:

PURPOSE:To present clinical findings of a cluster of cases of toxic anterior segment syndrome (TASS) after uneventful phacoemulsification cataract surgery. SETTING:Department of Ophthalmology, Akdeniz University, Antalya, Turkey. METHODS:Six eyes of 6 patients developed TASS after uneventful phacoemulsification cataract surgery with implantation of a 3-piece acrylic IOL performed by 2 ophthalmologists on the same day. Clinical findings included corneal edema, Descemet's membrane folds, anterior chamber reaction, fibrin formation, and irregular, dilated, and unreactive pupils. RESULTS:Glutaraldehyde 2% solution was used inadvertently by the operating room staff who cleaned and sterilized reusable ocular instruments before autoclaving. None of the affected corneas improved. Additional surgical procedures were required and included penetrating keratoplasty, trabeculectomy, and glaucoma tube implantation. CONCLUSIONS:Glutaraldehyde in concentrations generally used for cold sterilization is highly toxic to the corneal endothelium. The operating room staff involved in sterilizing instruments should be well educated about and careful to follow the protocols to properly clean and sterilize reusable ocular instruments.

authors

Unal M,Yücel I,Akar Y,Oner A,Altin M

doi

10.1016/j.jcrs.2006.05.008

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

1696-701

issue

10

eissn

0886-3350

issn

1873-4502

pii

S0886-3350(06)00872-8

journal_volume

32

pub_type

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