title: The role of patient's systemic characteristics and plateletcrit in developing toxic anterior segment syndrome after uneventful phaco surgery: A case-control study.
abstract: OBJECTIVE
  To compare the systemic and ocular characteristics and laboratory findings of patients developing toxic anterior segment syndrome (TASS) after uneventful phaco surgery with unaffected subjects undergoing the same surgery in the same session.
  
  
  METHODS
  A retrospective case-control study.
  
  
  METHODS
  The study group consisted of 26 eyes of 26 patients who underwent uneventful phaco surgery and who went on to develop TASS, while the control group included 39 subjects who had routine phaco surgery in the same session by the same surgeon. The sterilization stages of reusable instruments, disposable instruments, and compositions were recorded. The preoperative systemic diseases, complete blood count parameters, glycosylated hemoglobin (HbA1c), biochemical parameters, thyroid hormone profiles, and the surgical features were compared between the two groups.
  
  
  RESULTS
  Type 2 diabetes mellitus (DM), systemic hypertension (HT), hyperlipidemia, chronic ischaemic heart disease, and chronic renal failure were significantly more common in the TASS group (p < 0.05). Proliferative diabetic retinopathy was also more frequent in the TASS group (p = 0.003). Mean HbA1c% values, white blood cell count, neutrophil/lymphocyte ratio, platelet counts, platelet distribution width, and plateletcrit parameters were significantly higher in the TASS group (p < 0.05). Multivariate logistic regression analysis revealed that a high plateletcrit level (p = 0.001, odds ratio [95% CI]; 22.27 [3.36-147.76]) and systemic HT (p = 0.044, odds ratio [95% CI]; 7.13 [1.05-48.12]) are independently associated with the development of TASS.
  
  
  CONCLUSIONS
  Although TASS may arise as a result of insufficient sterilization of instruments or intraocular solutions, patient factors may also contribute to its development. Systemic vascular disorders such as uncontrolled type 2 DM, systemic hypertension, and hyperlipidemia may increase the risk of TASS after uneventful phaco surgery. Abnormal parameters associated with systemic inflammation, such as higher plateletcrit level, may facilitate the development of TASS. These findings may be a predicting factor of TASS development for uneventful cataract surgeries.
authors.affiliation: Department of Ophthalmology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Yazgan
authors.affiliation: Department of Ophthalmology, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey. h.ugurcelik@gmail.com.|Sahrayicedid Mahallesi, Batman Sok. Bedia Hanım Apt. No:23/9 Kadıköy, Istanbul, Turkey. h.ugurcelik@gmail.com.
authors.forename: Ugur
authors.initials: U
authors.lastname: Celik
authors.affiliation: Department of Ophthalmology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Orhan
authors.initials: O
authors.lastname: Ayar
authors.affiliation: Department of Ophthalmology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Suat Hayri
authors.initials: SH
authors.lastname: Ugurbas
authors.affiliation: Department of Ophthalmology, Haydarpasa Training and Research Hospital, Istanbul, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Celik
authors.affiliation: Department of Ophthalmology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Mehmet Orçun
authors.initials: MO
authors.lastname: Akdemir
authors.affiliation: Department of Ophthalmology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Silay Canturk
authors.initials: SC
authors.lastname: Ugurbas
authors.affiliation: Department of Ophthalmology, Medical Faculty, Bulent Ecevit University, Zonguldak, Turkey.
authors.forename: Atilla
authors.initials: A
authors.lastname: Alpay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000869:Anterior Eye Segment / Q000473:pathology*; D001792:Blood Platelets / Q000502:physiology*; D016022:Case-Control Studies; D015897:Comorbidity; D005128:Eye Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006400:Hematocrit; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome
keywords: Plateletcrit; Systemic diseases; Toxic anterior segment syndrome