OphthalmologyWeb
Toxic Anterior Segment Syndrome: Common Offenders C. M. Cutler Peck; J. W. Brubaker; H. Edelhauser; N. Mamalis
Causes found in survey in 2007-2008
40 site visits
#1 = inadequate flushing of phaco and I/A handpieces. Rec is 120 cc of fluid per port. Should be done immediately after surgery. Need to use deionized water for the final flush
- Use of enzymatic cleaners. Shouldn’t be necessary if flushing done properly.
- Use of ultrasonic baths (can harbor Gram neg bacteria, then can produce endotoxins)
- Use of antibiotics in BSS or intracamaral injection -- pH <6.5 or >8.5 bad
- BAK or other preservative in BSS (e.g. preserved epinephrine)
- Re-use of disposable sleeves, cannulas, etc.