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If TASS develops, then there is usually a need for intraocular aqueous and vitreous tap tash71 for culture to rule out other diagnoses such as infection. In severe cases of TASS with persistent corneal edema, patients may need corneal transplantation. In refractory glaucoma, the eye pressure should be closely monitored. If the pressure is not responsive to medical management, glaucoma surgery may be necessary. TASS is a post surgical event after an anterior segment surgery.
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As with all cases of post-operative inflammation following cataract surgery, endophthalmitis must be considered. In the case presented here, there was a lower suspicion for endophthalmitis as symptoms were very acute in onset—within 24 hours of surgery, and the inflammation was predominantly anterior without evidence of vitritis. An additional characteristic of TASS includes limited description of pain from the patient; blurry vision predominates.
At post-operative week six, visual acuity had improved to 20/30 in the affected eye. Although most surgeons have abandoned intracameral use of agents containing preservatives, inadvertent administration of these preservatives may result in TASS. Benzalkonium chloride is a frequently cited offender, and care should be taken to ensure medications instilled intracamerally do not contain this preservative (69-71). This agent not only causes dose-related inflammation to extraocular structures like the conjunctiva, it is also reported to make structural alterations to the endothelium even at exceedingly low concentrations (110). It is generally recommended to avoid the intraocular use of medications and solutions that contain benzalkonium chloride, thimerosal, eidetic acid, and sodium bisulfite (111). Similar to endophthalmitis, TASS cannot be prevented completely but the rate may be reduced.