title: Toxic anterior segment syndrome following iris-supported phakic IOL implantation with viscoelastic Multivisc BD.
abstract: 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.
authors.affiliation: TA University, Tel Aviv, Israel. galitseti@enaim.co.it
authors.forename: Israel
authors.initials: I
authors.lastname: Kremer
authors.forename: Eliya
authors.initials: E
authors.lastname: Levinger
authors.forename: Samuel
authors.initials: S
authors.lastname: Levinger
mesh_terms: 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*
chemical_list: D005938:Glucocorticoids; D055682:Viscoelastic Substances