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Barium-induced toxic anterior segment syndrome.

Kenji Matsushita1, Rumi Kawashima1, Noriyasu Hashida1

  • 1Department of Ophthalmology, Graduate School of Medicine, Osaka University, Osaka, Japan.

European Journal of Ophthalmology
|December 30, 2021
PubMed
Summary

Toxic anterior segment syndrome (TASS) can occur after eye surgery. A case following Baerveldt glaucoma implant (BGI) surgery was linked to barium from the implant causing severe eye inflammation.

Keywords:
Glaucomabaerveldt glaucoma implantbariuminductively coupled plasma-mass spectrometrytoxic anterior segment syndrome

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Area of Science:

  • Ophthalmology
  • Materials Science
  • Toxicology

Background:

  • Toxic anterior segment syndrome (TASS) is an acute intraocular inflammation.
  • It typically occurs after uneventful ocular surgeries.
  • Prompt diagnosis and management are crucial for visual outcomes.

Observation:

  • A patient developed TASS following Baerveldt glaucoma implant (BGI) surgery.
  • The patient presented with characteristic signs of severe anterior segment inflammation.
  • No other intraoperative or postoperative complications were noted.

Findings:

  • Inductively coupled plasma-mass spectrometry (ICP-MS) detected barium in the aqueous humor.
  • Barium was also identified in the fluid eluting from the BGI bleb.
  • These findings suggest a link between the BGI material and the TASS episode.

Implications:

  • The Baerveldt glaucoma implant may be a source of barium exposure.
  • Barium dissolution from the implant could trigger severe TASS.
  • This highlights the importance of material biocompatibility in glaucoma device design.