Investigation of Inflammation Syndrome Following Cataract Surgeries 

Public Health – Seattle & King County is investigating cases of toxic anterior segment syndrome (TASS) after eye surgeries at three King County facilities. TASS is an acute, noninfectious inflammation of the eye that results when a foreign substance is introduced into the eye during surgery, typically cataract surgery. TASS is an uncommon complication and usually results from exposure to contaminants in medications or on surgical instruments used in the eye during eye surgery. Most cases of TASS can be treated successfully with topical steroids and anti-inflammatory treatments, but in the worst cases, TASS can lead to vision loss.

The risk of contracting TASS is very low and the benefits of cataract surgery can be significant; we are not recommending delaying or canceling cataract surgery at this time. The Washington State Department of Health, the Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration (FDA) are assisting with the investigation.

TASS in King County

Three eye surgical centers in King County (Proliance Seattle Surgery Center, Eye Associates Northwest Surgery Center, and Proliance Eastside Surgery Center) have reported a total of 15 patients who have been diagnosed with TASS following cataract surgery during January–July.  All patients are improving or have recovered without complications. All three facilities promptly reported the cases to the American Society of Cataract and Refractive Surgery (ASCRS) TASS Task Force and implemented recommendations from the Task Force, including careful evaluation of and adherence to cleaning, sterilization, and other prevention measures.

Investigating TASS

At this point in the investigation, the cause of the TASS cases has not been determined. Possible causes include preservatives or toxins in medications or products, or from medication or instrument handling procedures within the facilities. It is not known how common TASS is in general and whether other patients have been affected.

We are continuing to look for factors that can be addressed to prevent future cases. To assist with the investigation, Public Health asks eye physicians and surgeons to report cases of TASS since January 2018 to 206-296-4774.

What to do if you are having cataract surgery

Cataract surgery is a common procedure. It’s important to know that the number of patients diagnosed with TASS represent less than one percent of patients who have received cataract surgery at these centers during this time period. Cataract surgery is a common procedure and during the months from January through July, these three facilities performed over 3,000 cataract surgeries that did not have complications from TASS. The risk of contracting TASS is very low and the benefits of cataract surgery can be significant; we are not recommending delaying or canceling cataract surgery at this time.

TASS symptoms normally develop within 12-48 hours following eye surgery.  Patients who experience any of the following symptoms following eye surgery should notify their eye doctor: vision loss or blurry vision, mild to moderate eye pain, eye redness, or extreme sensitivity to light.

Patients who are concerned about TASS should discuss the risks and benefits of eye surgery with their eye doctor.

Originally posted on August 8, 2018.

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I am a risk communications specialist at Public Health - Seattle & King County.

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