Postoperative Endophthalmitis and Toxic Anterior Segment Syndrome Prophylaxis: 2020 Update.

Improved surgical techniques have led to an increase in the number of outpatient ophthalmic procedures. In spite of decreased surgical times and overall improved outcomes, endophthalmitis remains one of the most severe complications of ophthalmic surgery. Although there are well known risk factors for postoperative endophthalmitis, some prophylaxis strategies remain controversial. A category of noninfectious postoperative inflammation, known as toxic anterior segment syndrome (TASS), is a rare but important complication of cataract surgery. While several worldwide outbreaks of TASS have occurred, it is challenging to identify an etiology in order to reduce the risk of further cases. Endophthalmitis and TASS cannot be prevented completely, but their rates may be decreased through risk reduction strategies supported by peer-reviewed evidence. This review highlights the current evidence in the prevention strategies for postoperative endophthalmitis and TASS.
Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/atm-2019-rcs-02). The series “Recent developments in cataract surgery” was commissioned by the editorial office without any funding or sponsorship. AG served as the unpaid Guest Editor of the series. SGS reports personal fees from Welch Allyn, outside the submitted work; and this study was supported in part by an unrestricted grant from Research to Prevent Blindness (New York, New York), NIH Center Core Grant P30EY014801 (Bethesda, Maryland), and the department of Defense (DOG Grant #W81XWH-09-1-0675) (Washington, D.C.). The sponsor or funding organization had no role in the design or conduct of this study. AG reports grants from Alcon, personal fees and non-financial support from Pfizer, personal fees from Santen, grants from Zeiss, grants from Bausch & Lomb, outside the submitted work. Dr. Flynn reports grants from Supported in part by NIH Center Core Grant P30EY014801 (Bethesda, Maryland) and Research to Prevent Blindness Unrestricted Grant to U.M during the conduct of the study. The other authors have no other conflicts of interest to declare.
(2020 Annals of Translational Medicine. All rights reserved.)