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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
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.
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.
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