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Toxic anterior segment syndrome after cataract surgery--Maine, 2006.

Toxic anterior segment syndrome (TASS), an acute, noninfectious inflammation of the anterior segment of the eye, is a complication of anterior segment eye surgery; cataract extraction is the most common form of this type of surgery. Various contaminants, usually from surgical equipment or supplies, have been implicated as causes of TASS. The syndrome typically develops within 24 hours after surgery and is characterized by corneal edema and accumulation of white cells in the anterior chamber of the eye. Although most cases of TASS can be treated successfully with topical steroids, topical nonsteroidal antiinflammatory agents, or both, the inflammatory response associated with TASS can cause serious damage to intraocular tissues, resulting in vision loss. In October 2006, the Maine Department of Health and Human Services (MDHHS) received a report of a cluster of TASS cases among outpatients who had undergone cataract surgery at a hospital in Maine. MDHHS and CDC investigated the cluster and worked with the treating ophthalmologist and the hospital to prevent additional cases. This report describes the results of that investigation and the subsequent prevention measures implemented. Although the specific cause of the outbreak was not identified, no additional cases were reported after two series of changes were made to the materials and equipment used for surgery. Prevention of TASS requires careful attention to solutions, medications, and ophthalmic devices and to cleaning and sterilization of surgical equipment because of the numerous potential causes of the condition.