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Case Reports
. 2015 Mar;41(3):666-9.
doi: 10.1016/j.jcrs.2015.01.002. Epub 2015 Feb 14.

Late-onset toxic anterior segment syndrome

Goichiro Miyake  1 , Ichiro Ota  1 , Kensaku Miyake  2 , Masahiro Zako  1 , Masayoshi Iwaki  1 , Akihiko Shibuya  1
Affiliations
Case Reports

Late-onset toxic anterior segment syndrome

Goichiro Miyake et al. J Cataract Refract Surg. 2015 Mar.

Abstract

We describe 6 cases that developed intraocular inflammation between 42 days and 137 days after implantation of an acrylic foldable intraocular lens (IOL) (ISert model 251) and failed to respond to antibiotic treatment. One eye required a vitrectomy and IOL removal, 2 eyes required irrigation of the capsule, and 5 eyes required systemic administration of steroids. The healing process took 30 to 108 days after onset. Simultaneous with our cases was an epidemic outbreak of sterile anterior segment inflammation with the same characteristics associated with the same IOL. The clinical features indicated late-onset toxic anterior segment syndrome. Analysis of the outbreak strongly suggested that toxicity of the aluminum used in the IOL production process was the cause. This contamination risk exists even with modern manufacturing technology.

Financial disclosure: Mr. Shibuya is an employee of Hoya Corporation Medical Division. No other author has a financial or proprietary interest in any material or method mentioned.

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