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Some instrument-cleaning practices need to be addressed to decrease TASS
Some instrument-cleaning practices need to be improved to decrease the risk of toxic anterior segment syndrome, a study found.
“Problems with the instrument-cleaning process, especially inadequate flushing of ophthalmic instruments and handpieces, enzymatic detergents, and [ultrasound] baths, remain the most common factors associated with TASS,” the study authors said.
The retrospective study analyzed surveys from centers that reported cases of toxic anterior segment syndrome (TASS) and information from visits to the affected sites. Results from June 1, 2009, to March 1, 2012, were compared to those from Jan. 1, 2007, to May 30, 2009. A total of 130 questionnaires and 71 sites visits were included from centers that performed about 69,000 surgeries and reported 1,454 cases of TASS.
Between the first reporting period and the second reporting period, there was a 26% decrease in sites that reported inadequate handpiece flushing volumes and a 27% increase in sites that used a deionized/distilled final rinse. For site visits, there was a 36% decrease in the use of preserved epinephrine and a 36% decrease in the use of enzymatic detergents.
However, despite these improvements, statistically significant “unfavorable changes” were found in some areas. There was a 21% increase in sites that handled IOLs or instrument tips with gloved hands, a 47% increase in sites with poor instrument maintenance and a 34% increase in sites where ultrasound baths were used without adequate routine cleaning.