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

BMJ Case Rep. 2018 Dec 3;11(1):bcr2018225806. doi: 10.1136/bcr-2018-225806.

Abstract

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.

Keywords: anterior chamber; eye.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anterior Eye Segment*
  • Diagnosis, Differential
  • 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
  • Lens Implantation, Intraocular / adverse effects*
  • Myopia / surgery*
  • Ophthalmic Solutions / administration & dosage
  • Ophthalmic Solutions / therapeutic use
  • Phakic Intraocular Lenses / adverse effects*
  • Postoperative Complications

Substances

  • Glucocorticoids
  • Ophthalmic Solutions
  • Fluprednisolone
  • difluprednate