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Toxic anterior segment syndrome-an updated review
Background
Toxic anterior segment syndrome (TASS) can be a rare complication of anterior segment surgery. Here we reviewed the most recent advances in the understanding of TASS.
Methods
English articles related to TASS were retrieved from “PubMed” using the following keywords; “toxic anterior segment syndrome” or “TASS”. The authors of this paper reviewed all the retrieved literature and critical findings were summarized.
Results
The onset of TASS can vary from hours to months. The clinical manifestations are also variable. The causes of TASS are broad and continue to expand and could not be elucidated in over half of the reported cases. Prompt and thorough investigation to explore the causes of TASS is critical. Surgeons should be fully aware and updated regarding possible etiologies and make ceaseless efforts to prevent TASS. This effort begins with establishing TASS prevention protocols and regularly training surgical staff. Proper cleaning of surgical instruments is critical and should follow the guidelines set by The American Society of Cataract and Refractive Surgery TASS Task Force. When TASS occurs, sharing information with other ophthalmologists and reporting new causes is crucial for the prevention of outbreaks.
Conclusions
Anterior segment surgeons should be reminded that TASS is mostly preventable by the establishment of TASS prevention protocols, regular surgical staff training and thorough adherence to recommendations for cleaning and sterilizing intraocular surgical instruments.
Journal Article
The association between toxic anterior segment syndrome and intraocular pressure
PurposeTo investigate the association between toxic anterior segment syndrome (TASS) and intraocular pressure (IOP).MethodsThis is a retrospective, controlled, single-site study. Patients who developed TASS following a clear corneal incision cataract surgery in Rabin Medical Center (Petah Tikva, Israel), between the years 2010–2018, were enrolled. The primary outcome was IOP measured 1, 7 (± 2), and 30 (± 7) days after surgery. The need for ocular hypotensive treatment was the secondary outcome.ResultsThe study and control groups included 374 and 127 eyes, respectively. The mean IOP in the study and the control groups were 16.3 ± 7.1 and 15.3 ± 3.0 (p = 0.02) at day 1, 13.2 ± 5.0 and 13.7 ± 2.9 (p = 0.18) at day 7, and 13.7 ± 4.1 and 13.5 ± 2.8 (p = 0.65) at day 30. Prevalence of high IOP (> 21 mmHg) was significantly higher in the study group solely on the first postoperative day (12.7% and 3.2%, p = 0.002). In the study group, 9%, 3.7%, and 1.6% of the patients required hypotensive medications at day 1, 7, and 30, respectively. Four patients (~ 1%) in the study group developed acute angle closure due to pupillary block, 1–3 weeks after surgery and required laser iridotomy and topical treatment.ConclusionHigh IOP is considered a concerning characteristic of the late stages of TASS although such association lack supporting evidence. This study did not detect such an association. High IOP was found only in a small group of TASS patients in the early perioperative period.
Journal Article
Toxic anterior segment syndrome (TASS): A review and update
Toxic anterior segment syndrome (TASS) is an acute, sterile, postoperative inflammatory reaction of the anterior segment without vitreous involvement, following an uncomplicated and uneventful ocular surgery, having broad and multiple etiologies. The symptoms of decreased visual acuity and ocular discomfort generally occur within the first 12-48 h after intraocular surgery. The clinical signs include prominent limbus-to-limbus corneal edema, anterior chamber cells, aqueous flare, fibrinous inflammation, and/or keratic precipitates. There can be sight-threatening complications of TASS, such as permanent corneal decompensation, intractable glaucoma, and cystoid macular edema. The causes of TASS are emerging and being reported, so are the newer treatment options for managing the inflammation and its complications. Prevention guidelines for TASS are being updated, and a traceability system for surgical instruments and intraocular fluids used during the surgery is being perpetually developed. It is important to recognize TASS and start treatment on an immediate effect. Hereby, we review the literature on TASS, emphasizing its etiology, pathophysiology, management, prognosis, complications, and the importance of prevention as well as prompt recognition.
Journal Article
Predicting and understanding forest dynamics using a simple tractable model
The perfect-plasticity approximation (PPA) is an analytically tractable model of forest dynamics, defined in terms of parameters for individual trees, including allometry, growth, and mortality. We estimated these parameters for the eight most common species on each of four soil types in the US Lake states (Michigan, Wisconsin, and Minnesota) by using short-term ([less-than or equal to]15-year) inventory data from individual trees. We implemented 100-year PPA simulations given these parameters and compared these predictions to chronosequences of stand development. Predictions for the timing and magnitude of basal area dynamics and ecological succession on each soil were accurate, and predictions for the diameter distribution of 100-year-old stands were correct in form and slope. For a given species, the PPA provides analytical metrics for early-successional performance (H₂₀, height of a 20-year-old open-grown tree) and late-successional performance (Z*, equilibrium canopy height in monoculture). These metrics predicted which species were early or late successional on each soil type. Decomposing Z* showed that (i) succession is driven both by superior understory performance and superior canopy performance of late-successional species, and (ii) performance differences primarily reflect differences in mortality rather than growth. The predicted late-successional dominants matched chronosequences on xeromesic (Quercus rubra) and mesic (codominance by Acer rubrum and Acer saccharum) soil. On hydromesic and hydric soils, the literature reports that the current dominant species in old stands (Thuja occidentalis) is now failing to regenerate. Consistent with this, the PPA predicted that, on these soils, stands are now succeeding to dominance by other late-successional species (e.g., Fraxinus nigra, A. rubrum).
Journal Article
Provenance and Age of Volcanogenic–Terrigenous Rocks of the Bastakh Series (Ilin–Tass Anticlinorium, Northeast Russia)
The rocks of the Ilin–Tass anticlinorium overlie the folded structures of the Moma Range and extend from the headwaters of the Kolyma River in the northwesterly direction to the Indigirka River basin. The first data on U–Pb dating of detrital zircons from volcanogenic–terrigenous rocks of the Bastakh series are presented. It is found that the provenance area for the rocks of the Bastakh series was located along the entire periphery from the area of accumulation of volcanogenic–sedimentary formations. It is shown that the age of the three formations of the Bastakh series lower in the section, which was previously considered to be the Tithonian, covers the Neocomian and is accepted as the Tithonian–Barremian.
Journal Article
Biofilm inhibiting nanocomposite coatings on stainless steel surgical instruments: a possible strategy to prevent TASS
Toxic anterior segment syndrome (TASS) is an inflammation that occurs after anterior segment surgeries, and is widely seen in the patients after cataract surgery. The main cause of TASS is postulated to be the bio-residue and heat stable endotoxins which persist on the used forceps even after autoclave sterilization, some of which are known to cause inflammation. In this work, initially, a detailed characterization of bio-residue composition before and after autoclave sterilization of the forceps used in ophthalmic surgeries was carried out by Fourier-transform infrared spectroscopy (FTIR) and gas chromatography mass spectrometry (GCMS) techniques. The morphological features of biofilm before and after autoclave were also examined using a field emission scanning electron microscope (FESEM). Subsequently, two biofilm inhibiting nanocomposite coating formulations which were earlier developed by us were deposited on stainless steel 420 coupons to mimic surgical instruments. Biofilm inhibition was studied for bare and coated substrates after autoclaving using crystal violet staining as well as by FESEM analysis. It was observed that the coated substrates prevented biofilm formation even after autoclaving. The results of this study demonstrate that the biofilm inhibiting coatings prevent formation of biofilm and hence, prevent deposition of bioresidues on stainless steel surgical instruments. Due to this, the coated surgical instruments are safe to use even after autoclaving and cannot be expected to cause any inflammatory responses after surgeries, thereby preventing TASS.
Journal Article
TASS - Workshop on Sentiment Analysis at SEPLN
This paper describes TASS, an experimental evaluation workshop within SEPLN to foster the research in the field of sentiment analysis in social media, specifically focused on Spanish language. The main objective is to promote the application of existing state-of-the-art algorithms and techniques and the design of new ones for the implementation of complex systems able to perform a sentiment analysis based on short text opinions extracted from social media messages (specifically Twitter) published by representative personalities. The paper presents the proposed tasks, the contents, format and main statistics of the generated corpus, the participant groups and their different approaches, and, finally, the overall results achieved.
Journal Article
The democratization of deep learning in TASS 2017
TASS 2017 has brought advances in the state-of-the-art in Sentiment Analysis in Spanish, because most of the systems submitted in 2017 were grounded on Deep Learning methods. Moreover, a new corpus of tweets written in Spanish was released, which is called InterTASS. The corpus is composed of tweets manually annotated at document level. The analysis of the results with InterTASS shows that the main challenge is the classification of tweets with a neutral opinion and those ones that do not express any opinion. Likewise, the organization exposed the project of extending InterTASS with tweets written in different versions of Spanish.
Journal Article