An investigation of enzymatic detergents as a potential cause of toxic anterior segment syndrome

Ophthalmology
Henry A LederMalvina B Eydelman

Abstract

To investigate whether enzymatic detergents used in cleaning ophthalmic surgical instruments can cause toxic anterior segment syndrome (TASS)-like responses in a rabbit model. Randomized, investigator-masked, controlled experimental animal study. Thirty-five New Zealand white rabbits. The rabbit eyes were randomized into 7 treatment groups to receive intracameral injection of 1 of 3 different doses of Medline Dual Detergent or Enzol Detergent, or sterile limulus amoebocyte lysate reagent water as a control. The eyes were evaluated for anterior segment inflammation at baseline and at 1, 3, 6, 24, 48, and 72 hours after treatment by slit-lamp biomicroscopy. Anterior chamber (AC) inflammation, including cells, flare, fibrin, and iris injection; time course of inflammation; and residual detergent levels in luminated instruments. Moderate to marked injection of the iris vessels was seen as early as 1 hour after treatment with the enzymatic detergents in 41 of 60 eyes, with the response being more severe in the Enzol Detergent-exposed eyes. Severe iris hemorrhages were accompanied by blood in the AC in 13 eyes, which usually persisted through 72 hours, with an associated increase in AC cell and flare. Corneal haze was present in 52 o...Continue Reading

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Citations

Sep 13, 2015·Cutaneous and Ocular Toxicology·Talal Abdulrahman Althomali
May 30, 2013·Ophthalmology·Nick Mamalis, Henry F Edelhauser
May 30, 2013·Ophthalmology·Henry A Leder, Malvina Eydelman
Oct 20, 2012·Journal of Cataract and Refractive Surgery·Nick Mamalis
Jul 4, 2012·Ophthalmology·John D Gottsch, Oliver D Schein
May 15, 2012·Ophthalmology·Malvina B EydelmanKesia Y Alexander
Apr 10, 2019·Journal of Ocular Pharmacology and Therapeutics : the Official Journal of the Association for Ocular Pharmacology and Therapeutics·Vladimir BantseevEvan A Thackaberry
Nov 30, 2018·Current Opinion in Ophthalmology·Karny Shouchane-BlumIrit Bahar
Dec 1, 2018·Vestnik oftalmologii·S N Svetozarskiy, A N Andreev
Jan 8, 2021·International Journal of Retina and Vitreous·Sukhum Silpa-ArchaJanine M Preble

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