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)
Slide 5
TASS The pathologic changes are limited to the anterior
chamber.
Slide 6
TASS is an acute inflammation of anterior segment of the eye
following cataract surgery. A variety of substances have been
implicated as causes of TASS.
Slide 7
1)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
Slide 8
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.
Slide 9
TASS presents within 12-24 hours whereas acute infectious
endophthalmitis typically develops 2-7 days after surgery.
Slide 10
TASS Other potentially distinguishing features of TASS include
1.diffuse, limbus-to- limbus corneal edema; 2. anterior chamber
opacification 3) a dilated, irregular or nonreactive pupil 4) and
elevated lOP.
Slide 11
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.
Slide 12
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,
Slide 13
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.
Slide 14
Infectious endophthalmitis caused by bacteria and fungi is
often difficult to distinguish from other types of intraocular
inflammation.
Slide 15
TASS Excessive inflammation without endophthalmitis is often
encountered postoperatively in the setting of 1. complicated
surgery, preexisting uveitis 2.keratitis, 3. diabetes, 4.glaucoma
therapy, and 5.previous surgery
Slide 16
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
