Identification of unknown intraocular material after cataract surgery: Evaluation of a potential cause of toxic anterior segment syndrome
| Autor: | Charles R. Bagnell, Kenneth C. Mathys, Kenneth L. Cohen |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Sodium Sodium hyaluronate Lens Capsule Crystalline chemistry.chemical_element Intraocular lens chemistry.chemical_compound Postoperative Complications Silicone Lens Implantation Intraocular Anterior Eye Segment Ophthalmology Humans Medicine Hyaluronic Acid Phacoemulsification business.industry Foreign-Body Reaction Chondroitin Sulfates Syndrome Toxic anterior segment syndrome medicine.disease Uveitis Anterior Sensory Systems Surgery Drug Combinations medicine.anatomical_structure chemistry Lens (anatomy) Microscopy Electron Scanning business Chondroitin Electron Probe Microanalysis |
| Zdroj: | Journal of Cataract and Refractive Surgery. 34:465-469 |
| ISSN: | 0886-3350 |
| DOI: | 10.1016/j.jcrs.2007.10.047 |
| Popis: | PURPOSE: To describe and identify unknown opaque material between the optic of an AR40 intraocular lens (IOL) injected with the Emerald Series implantation system (both AMO, Inc.) and the posterior capsule at the conclusion of routine phacoemulsification to prevent an outbreak of toxic anterior segment syndrome (TASS). SETTING: Ambulatory care center operating room, University of North Carolina Hospitals and Department of Ophthalmology, University of North Carolina School of Medicine at Chapel Hill, Chapel Hill, North Carolina, USA. METHODS: After coaxial phacoemulsification in multiple patients, opaque material was present between the optic of a posterior chamber IOL and the posterior capsule. Although there was no TASS, the material was removed from 2 eyes and analyzed with scanning electron microscopy (SEM) and x-ray microanalysis (XRM). Similarly, crystalline lens, Klenzyme (Steris Corp.), Viscoat (sodium hyaluronate 3.0%-chondroitin sulfate 4.0%), and Provisc (sodium hyaluronate 1.0%) were analyzed. RESULTS: On SEM, the material had an irregular undulating surface similar to that of Provisc. Viscoat and the crystalline lens had smoother surfaces. On XRM, the material contained sodium, chlorine, and calcium, like Viscoat and Provisc, and phosphorous and sulfur, like Viscoat. The material also contained silicone, magnesium, aluminum, titanium, iron, and zinc. Klenzyme had smaller peaks of sodium, chlorine, and calcium and a higher carbon background than the unknown material. CONCLUSIONS: The material was likely ophthalmic viscosurgical device that was chemically and structurally altered by the cleaning and sterilization process. The silicone and metallic elements were probably from the Emerald Series implantation system as the disposable cartridge is coated with silicone and the reusable injector is metal. |
| Databáze: | OpenAIRE |
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