Outbreak of toxic anterior segment syndrome following cataract surgery associated with impurities in autoclave steam moisture

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Walter C HellingerHenry F Edelhauser

Abstract

Toxic anterior segment syndrome (TASS), a complication of cataract surgery, is a sterile inflammation of the anterior chamber of the eye. An outbreak of TASS was recognized at an outpatient surgical center and its affiliated hospital in December 2002. Medical records of patients who underwent cataract surgery during the outbreak were reviewed, and surgical team members who participated in the operations were interviewed. Potential causes of TASS were identified and eliminated. Feedwater from autoclave steam generators and steam condensates were analyzed by use of spectroscopy and ion chromatography. During the outbreak, 8 (38%) of 21 cataract operations were complicated by TASS, compared with 2 (0.07%) of 2,713 operations performed from January 1996 through November 2002. Results of an initial investigation suggested that cataract surgical equipment may have been contaminated by suboptimal equipment reprocessing or as a result of personnel changes. The frequency of TASS decreased (1 of 44 cataract operations) after reassignment of personnel and revision of equipment reprocessing procedures. Further investigation identified the presence of impurities (eg, sulfates, copper, zinc, nickel, and silica) in autoclave steam moisture, w...Continue Reading

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Citations

Sep 19, 2009·Japanese Journal of Ophthalmology·Akira SakimotoAkiko Ishimori
Feb 23, 2010·Retina·Thomas NessBeate Lubrich
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