[Toxic Anterior Segment Syndrome (TASS): studying an outbreak].
BACKGROUND
An effect associated with cataract surgery known as Toxic Anterior Segment Syndrome (TASS) has been reported in recent years. It is an inflammatory non-infectious process which appears within the first few hours after surgery and generally resolves well with topical steroids if the course of treatment is started promptly. In this paper we describe the syndrome and analyze the possible causes for the TASS outbreak that occurred in our hospital and affected 5 patients.


METHODS
As the syndrome may be due to multiple causes, the members of a research team created at the hospital reviewed all the procedures involved. The washing and sterilization methods applied to the materials were analyzed, as well as the drugs and substances used which might have caused the outbreak. We verified the substances prepared by the Pharmacy Department, specially the irrigating solution which was used in all the cases.


RESULTS
According to the results obtained in the biochemical, micro-biological, pH, osmolarity and endotoxins assays, the solutions prepared by the Pharmacy Department were all correct.


CONCLUSIONS
Since the results obtained in the analyses of the substances used were correct and no adverse effect was observed after the re-administration of the substances, we may conclude that the outbreak would be related to the washing process performed previously to the sterilization of the instrumentation used in the surgery, mainly because the recommendation to use distilled and sterile water for this purpose was not followed and, on the contrary, tap water continued to be used.
Sarobe Carricas
M
M
Servicio de Farmacia, Hospital de Navarra, Pamplona, España. msarobec@cfnavarra.es
Segrelles Bellmunt
G
G
Jiménez Lasanta
L
L
Iruin Sanz
A
A
D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment; D002387:Cataract Extraction / Q000009:adverse effects*; D004196:Disease Outbreaks; D005128:Eye Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged