Toxic anterior segment syndrome: Clinical and histopathological findings [Toksik anterior segment sendromu: Klinik ve histopatolojik bulgular]
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Purpose: To analyze the clinical and histopathological findings of toxic anterior segment syndrome (TASS) which can be developed after phacoemulsification surgery. Material and Method: We evaluated the cases of three patients who developed TASS after uneventful phacoemulsification operations performed by the same surgeon in the same session. All patients were examined at the 1st, 12th, 24th, and 48th hours postoperatively. Further follow-up visits were planned as needed. Corneal decompensation developed in all three cases. One patient underwent evisceration and another one - penetrating keratoplasty. Both corneas were analyzed histopathologically. Results: The patients were between 61 and 73 years of age and all were male. Blurred vision without pain, limbus-tolimbus corneal edema and hypopyon were observed in all three cases. In each case, the iris was irregularly dilated and atrophic. Histopathological evaluation showed that the endothelial cell layer has disappeared completely in two corneas. The third case suffered loss of vision due to corneal decompensation and glaucoma refractory to medical treatment. Discussion: TASS is a serious complication, which can result in complete loss of corneal endothelial layer. It is important that switching to disposable instruments and/or adequate cleaning of the surgical instruments will reduce the TASS complication.