| Nd:YAG Photodisruption of Toxic Anterior Segment Syndrome Related to Amoeboic Deposits. |
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In Ki Park, Jae Hoon Kim, Jae Chan Kim, Yeoun Sook Chun |
1Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
2Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. yschun100@hanmail.net |
| 아메바 모양의 침착물을 동반한 독성 전방 증후군에서 야그레이저를 이용한 치료 |
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박인기1⋅김재훈2⋅김재찬2⋅전연숙2 |
Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine1, Seoul, Korea
Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine2, Seoul, Korea |
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| Abstract |
PURPOSE
To report 3 unusual cases of toxic anterior segment syndrome resembling transparent amoeboid deposits following cataract surgery and to determine effective treatment methods. CASE SUMMARY: Three patients underwent uneventful phacoemulsification with implantation of a hydrophobic acrylic intraocular lens (IOL) and patching with antibiotic/steroid ointment at the end of surgery. At a mean of 15 days postoperatively, a significant number of anterior chamber inflammatory cells and multiple transparent amoeboid deposits with central, elevated, gray-white opaque material on the anterior surface of the IOL were observed. In two cases, greasy material coated the anterior surface of the IOL in a wavy pattern. All laboratory tests to exclude infectious endophthalmitis were negative. Presuming postoperative inflammation, intensive topical steroid was administered. After treatment, anterior chamber reactions decreased; however, the multiple whitish deposits remained. Subsequently, a Nd:YAG laser (0.8 mJ) was used to disrupt and remove the precipitates. The masses were easily and obviously removed by laser therapy, and the mild residual inflammation resolved satisfactorily with mild topical steroid treatment. No recurrence or related complications developed during the two-year follow-up period in any patients. CONCLUSIONS: The delayed postoperative inflammation onset resembling amoeboid deposits is thought to be caused by ingress of ointment into the eye. The specific lumpy deposits cannot be controlled with topical steroids, although Nd:YAG laser treatment can effectively remove inflammatory cell deposits mingled with greasy oil material. |
| Key Words:
Amoeboic deposit;Cataract;Nd:YAG laser;Ointment;Toxic anterior segment syndrome |
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