PDF(Pubmed)
Abstract：
BACKGROUND: Toxic anterior segment syndrome (TASS) is a rare, noninfectious inflammation that occurs after anterior segment surgery. We report a case herein that developed presumed atypical late-onset TASS after V4c implantable collamer lens (ICL) implantation surgery.
METHODS: A 26-year-old man underwent ICL implantation surgeries of both eyes on two separate days. The 1-day and 7-day postoperative routine follow-up visits revealed no abnormalities. However, one month after surgery, dense white spots attached to the posterior surface and scattered ones to the anterior surface of ICL in the left eye were noted on anterior segment examination. His uncorrected distance visual acuity (UDVA) was 20/16 in both eyes and the fundus examination was normal. Despite the absence of typical clinical manifestations, late-onset TASS was suspect and intense topical steroid was administered. After 6 weeks of tapering topical steroid therapy, the white spots disappeared and the patient had no subjective complains throughout the treatment period.
CONCLUSIONS: This case suggested that the traditionally considered acute and serious TASS could also present as delayed and insidious onset after ICL implantation surgery. Due to its variabilities, the awareness of TASS should be raised to ophthalmologists and regular follow-up visits should be emphasized to patients. Once TASS was suspected, intensive steroid therapy should be implemented in time.
METHODS: A 26-year-old man underwent ICL implantation surgeries of both eyes on two separate days. The 1-day and 7-day postoperative routine follow-up visits revealed no abnormalities. However, one month after surgery, dense white spots attached to the posterior surface and scattered ones to the anterior surface of ICL in the left eye were noted on anterior segment examination. His uncorrected distance visual acuity (UDVA) was 20/16 in both eyes and the fundus examination was normal. Despite the absence of typical clinical manifestations, late-onset TASS was suspect and intense topical steroid was administered. After 6 weeks of tapering topical steroid therapy, the white spots disappeared and the patient had no subjective complains throughout the treatment period.
CONCLUSIONS: This case suggested that the traditionally considered acute and serious TASS could also present as delayed and insidious onset after ICL implantation surgery. Due to its variabilities, the awareness of TASS should be raised to ophthalmologists and regular follow-up visits should be emphasized to patients. Once TASS was suspected, intensive steroid therapy should be implemented in time.
摘要：
背景：毒性眼前节综合征（TASS）是一种罕见的，前节手术后发生的非感染性炎症。我们在此报告了一个病例，该病例在V4c植入式结晶体（ICL）植入手术后出现了推测的非典型迟发性TASS。
方法：一名26岁的男性在两天内接受了双眼ICL植入手术。术后1天和7天的常规随访未发现异常。然而,手术后一个月,眼前段检查发现左眼ICL后表面有密集的白点，前表面有分散的白点。他的双眼未矫正视力（UDVA）为20/16，眼底检查正常。尽管没有典型的临床表现，迟发性TASS是可疑的,并给予强烈的局部类固醇.6周后逐渐减少局部类固醇治疗，白斑消失,患者在整个治疗期间没有主观症状.
结论：该病例表明，传统上认为的急性和严重的TASS也可能表现为ICL植入手术后的延迟和隐伏发作。由于其可变性,应提高眼科医生对TASS的认识,并强调定期对患者进行随访.一旦TASS被怀疑,应及时实施强化类固醇治疗。
方法：一名26岁的男性在两天内接受了双眼ICL植入手术。术后1天和7天的常规随访未发现异常。然而,手术后一个月,眼前段检查发现左眼ICL后表面有密集的白点，前表面有分散的白点。他的双眼未矫正视力（UDVA）为20/16，眼底检查正常。尽管没有典型的临床表现，迟发性TASS是可疑的,并给予强烈的局部类固醇.6周后逐渐减少局部类固醇治疗，白斑消失,患者在整个治疗期间没有主观症状.
结论：该病例表明，传统上认为的急性和严重的TASS也可能表现为ICL植入手术后的延迟和隐伏发作。由于其可变性,应提高眼科医生对TASS的认识,并强调定期对患者进行随访.一旦TASS被怀疑,应及时实施强化类固醇治疗。
