Nd:YAG Photodisruption of Toxic Anterior Segment Syndrome Related to Amoeboic Deposits.
10.3341/jkos.2012.53.9.1334
- Author:
In Ki PARK
1
;
Jae Hoon KIM
;
Jae Chan KIM
;
Yeoun Sook CHUN
Author Information
1. Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Amoeboic deposit;
Cataract;
Nd:YAG laser;
Ointment;
Toxic anterior segment syndrome
- MeSH:
Anterior Chamber;
Cataract;
Endophthalmitis;
Eye;
Follow-Up Studies;
Humans;
Inflammation;
Laser Therapy;
Lenses, Intraocular;
Phacoemulsification;
Recurrence;
Steroids
- From:Journal of the Korean Ophthalmological Society
2012;53(9):1334-1340
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report 3 unusual cases of toxic anterior segment syndrome resembling transparent amoeboid deposits following cataract surgery and to determine effective treatment methods. CASE SUMMARY: Three patients underwent uneventful phacoemulsification with implantation of a hydrophobic acrylic intraocular lens (IOL) and patching with antibiotic/steroid ointment at the end of surgery. At a mean of 15 days postoperatively, a significant number of anterior chamber inflammatory cells and multiple transparent amoeboid deposits with central, elevated, gray-white opaque material on the anterior surface of the IOL were observed. In two cases, greasy material coated the anterior surface of the IOL in a wavy pattern. All laboratory tests to exclude infectious endophthalmitis were negative. Presuming postoperative inflammation, intensive topical steroid was administered. After treatment, anterior chamber reactions decreased; however, the multiple whitish deposits remained. Subsequently, a Nd:YAG laser (0.8 mJ) was used to disrupt and remove the precipitates. The masses were easily and obviously removed by laser therapy, and the mild residual inflammation resolved satisfactorily with mild topical steroid treatment. No recurrence or related complications developed during the two-year follow-up period in any patients. CONCLUSIONS: The delayed postoperative inflammation onset resembling amoeboid deposits is thought to be caused by ingress of ointment into the eye. The specific lumpy deposits cannot be controlled with topical steroids, although Nd:YAG laser treatment can effectively remove inflammatory cell deposits mingled with greasy oil material.
