Risk of developing toxic anterior segment syndrome post cataract surgery in the fellow eye, after previous TASS in the first eye surgery

Background We collected data from 140 patients who developed Toxic Anterior Segment Syndrome (TASS) after cataract surgeries between 2011–2019. Complete records documenting surgery in both eyes were available in 94 patients, with 83 of them developing TASS in one eye, and 11 in both eyes. We compared them by age, gender, post-operative visual acuity (VA), and medical disorders. Purpose To evaluate the incidence and potential risk factors of TASS in the fellow eye following a previous episode of TASS in the first eye, and to propose clinical considerations for fellow eye surgery. Results The proportion (risk) of developing TASS in the second (fellow) eye after TASS in the first eye was 14.5% ( n = 11 of 76). The risk of developing TASS in both eyes among those who developed TASS in either eye was 11.7% ( n = 11 of 94). Relative risk for bilateral TASS was 4.3 times greater for simultaneous than separate surgeries. TASS often appeared in clusters, and age was not a significant risk factor. Also, there was no significant difference regarding systemic medical problems or VA. Significant correlation was found between TASS and implanted lens type. Conclusion Intrinsic patient-specific factors may affect TASS development in addition to environmental factors, suggesting caution performing surgery on the fellow eye.