Toxic anterior segment syndrome following iris-supported phakic IOL implantation with viscoelastic Multivisc BD.
OBJECTIVE
To report on the association between Multivisc BD and toxic anterior segment syndrome (TASS) post phakic intraocular lens (IOL) implantation.


METHODS
Two patients developed severe toxic anterior chamber inflammation following implantation of phakic iris fixated IOL with Multivisc BD viscoelastic. Anterior chamber washout was performed with intracameral antibiotic injection. Local antibiotics were continued until cultures were found to be negative. Thereafter, intensive local and systemic steroids were initiated and gradually tapered down.


RESULTS
The inflammatory reaction disappeared completely and the visual acuity improved from hand motion to 6/9 without correction within 1 week.


CONCLUSIONS
Any viscoelastic material may be contaminated by heat-stable bacterial endotoxic as it is prepared by gene-coded bacteria. It is suggested that Multivisc BD was the etiologic factor of TASS. Refractive surgeons should be aware of this rare complication of phakic IOL implantation whenever they use a new viscoelastic material.
Kremer
Israel
I
TA University, Tel Aviv, Israel. galitseti@enaim.co.it
Levinger
Eliya
E
Levinger
Samuel
S
D000869:Anterior Eye Segment / Q000187:drug effects* / Q000473:pathology; D003937:Diagnosis, Differential; D009877:Endophthalmitis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007267:Injections; D007498:Iris / Q000601:surgery*; D019654:Lens Implantation, Intraocular / Q000009:adverse effects* / Q000379:methods; D013536:Suture Techniques / Q000009:adverse effects*; D013577:Syndrome; D055682:Viscoelastic Substances / Q000009:adverse effects*
D005938:Glucocorticoids; D055682:Viscoelastic Substances