Síndrome tóxica do segmento anterior após cirurgias de catarata: implicações para a enfermagem

Autores

  • Reginaldo Adalberto Luz Professor da Escola de Enfermagem da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP
  • Maria Clara Padoveze Prof.ª Dra. no Departamento de Enfermagem em Saúde Coletiva, Escola de Enfermagem, Universidade de São Paulo, USP
  • Rafael Queiroz de Souza Professor de Pós-graduação do Centro Universitário São Camilo.
  • Kazuko Uchikawa Graziano Professora Titular do Departamento de Enfermagem Médico-Cirúrgica da Escola de Enfermagem da USP.
  • Tadeu Cvintal Médico Oftalmologista do Instituto de Oftalmologia Tadeu Cvintal.

DOI:

https://doi.org/10.5327/Z1414-4425201500020005

Palavras-chave:

Extração de catarata, Enfermagem perioperatória, Vigilância epidemiológica, Esterilização, Endoftalmite

Resumo

Objetivo: Descrever as características da síndrome tóxica do segmento anterior (TASS) e as implicações para as ações de enfermagem. Método: Trata-se de uma revisão da literatura por meio de pesquisa nas bases de dados Medical Literature Analysis and Retrievel System Online (MEDLINE) e Literatura Latino-Americana em Ciências da Saúde (LILACS). Resultados: A TASS é uma reação inflamatória ocular aguda após cirurgias oftálmicas, principalmente a cirurgia de catarata, cuja apresentação clínica nas primeiras 12 horas após o procedimento inclui sinais como edema da córnea, presença de células na câmara anterior (CA), pressão intraocular aumentada e pupila irregular. As principais causas estão relacionadas com substâncias não infecciosas introduzidas no olho do paciente a partir de produtos usados durante a cirurgia ou devido a falhas no processamento dos instrumentais. Conclusão: As implicações para a enfermagem consistem nas medidas de prevenção, treinamento de pessoal, orientação aos pacientes e vigilância epidemiológica ativa visando à identificação precoce de sinais indicativos da TASS.

Referências

Choi JS, Shyn KH. Development of toxic anterior segment syndrome immediately after uneventful phaco surgery. Korean J Ophthalmol. 2008;22(4):220-7.

Unal M, Yucel I, Akar Y, Oner A, Altin M. Outbreak of toxic anterior segment syndrome associated with glutaraldehyde after cataract surgery. J Cataract Refract Surg. 2006;32(10):1696-701.

Werner L, Sher JH, Taylor JR, Mamalis N, Nash WA, Csordas JE, et al. Toxic anterior segment syndrome and possible association with ointment in the anterior chamber following cataract surgery. J Cataract Refract Surg. 2006;32(2):227-35.

Monson MC, Mamalis N, Olson RJ. Toxic anterior segment inflammation following cataract surgery. J Cataract Refract Surg. 1992;18(2):184-9.

Mamalis N. Inflamation. In: Charlton JF. Ophthalmic surgery complications: prevention and management. Michigan: Lippincott; 1995. p. 313-32.

Andonegui J, Jimenez-Lasanta L, Aliseda D, Lameiro F. Outbreak of toxic anterior segment syndrome after vitreous surgery. Arch Soc Esp Oftalmol. 2009;84(8):403-5.

Moisseiev E, Barak A. Toxic anterior segment syndrome outbreak after vitrectomy and silicone oil injection. Eur J Ophthalmol. 2012;22(5):803-7.

Maier P, Birnbaum F, Bohringer D, Reinhard T. Toxic anterior segment syndrome following penetrating keratoplasty. Arch Ophthalmol. 2008;126(12):1677-81.

Shunmugam M, Hugkulstone CE, Wong R, Williamson TH. Consecutive toxic anterior segment syndrome in combined phaco- vitrectomy. Int Ophthalmol. 2013;33(3):289-90.

Alves LFA, Kac MJ, Bisol T, Fernandes BF, Eskenazi DT. Síndrome tóxica do segmento anterior. Rev Bras Oftalmol. 2013;72(1):29-33.

Hellinger WC, Hasan SA, Bacalis LP, Thornblom DM, Beckmann SC, Blackmore C, et al. Outbreak of toxic anterior segment syndrome following cataract surgery associated with impurities in autoclave steam moisture. Infect Control Hosp Epidemiol. 2006;27(3):294-8.

Sengupta S, Chang DF, Gandhi R, Kenia H, Venkatesh R. Incidence and long-term outcomes of toxic anterior segment syndrome at Aravind Eye Hospital. J Cataract Refract Surg. 2011;37(9):1673-8.

Ozcelik ND, Eltutar K, Bilgin B. Toxic anterior segment syndrome after uncomplicated cataract surgery. Eur J Ophthalmol. 2010;20(1):106-14.

Nizamani NB, Bhutto IA, Talpur KI. Cluster of Urrets-Zavalia syndrome: a sequel of toxic anterior segment syndrome. Br J Ophthalmol. 2013;97(8):976-9.

Ari S, Caca I, Sahin A, Cingu AK. Toxic anterior segment syndrome subsequent to pediatric cataract surgery. Cutan Ocul Toxicol. 2012;31(1):53-7.

Moyle W, Yee RD, Burns JK, Biggins T. Two consecutive clusters of toxic anterior segment syndrome. Optom Vis Sci. 2013;90(1):e11-23.

Avisar R, Weinberger D. Corneal endothelial morphologic features in toxic anterior segment syndrome. Cornea. 2010;29(3):251-3.

Jehan FS, Mamalis N, Spencer TS, Fry LL, Kerstine RS, Olson RJ. Postoperative sterile endophthalmitis (TASS) associated with the memorylens. J Cataract Refract Surg. 2000;26(12):1773-7.

Kremer I, Levinger E, Levinger S. Toxic anterior segment syndrome following iris-supported phakic IOL implantation with viscoelastic Multivisc BD. Eur J Ophthalmol. 2010;20(2):451-3.

Buzard K, Zhang JR, Thumann G, Stripecke R, Sunalp M. Two cases of toxic anterior segment syndrome from generic trypan blue. J Cataract Refract Surg. 2010;36(12):2195-9.

Van Philips LA. Toxic anterior segment syndrome after foldable artiflex iris-fixated phakic intraocular lens implantation. J Ophthalmol. 2011;2011:982410.

Huang Y, Dai Y, Wu X, Lan J, Xie L. Toxic anterior segment syndrome after pediatric cataract surgery. J AAPOS. 2010;14(5):444-6.

Pineda 2nd R, Jain V, Gupta P, Jakobiec FA. Descemet’s stripping endothelial keratoplasty: an effective treatment for toxic anterior segment syndrome with histopathologic findings. Cornea. 2010;29(6):694-7.

Arslan OS, Unal M, Arici C, Gorgun E, Yenerel M, Cicik E. Descemet-stripping automated endothelial keratoplasty in eyes with toxic anterior segment syndrome after cataract surgery. J Cataract Refract Surg. 2010;36(6):965-9.

Moshirfar M, Whitehead G, Beutler BC, Mamalis N. Toxic anterior segment syndrome after Verisyse iris-supported phakic intraocular lens implantation. J Cataract Refract Surg. 2006;32(7):1233-7.

Jun EJ, Chung SK. Toxic anterior segment syndrome after cataract surgery. J Cataract Refract Surg. 2010;36(2):344-6.

Kelley M, Srinivasan A, Pelletier A. Toxic Anterior Segment Syndrome After Cataract Surgery — Maine, 2006. MMWR. 2007;56(25):629-30.

Cutler Peck CM, Brubaker J, Clouser S, Danford C, Edelhauser HE, Mamalis N. Toxic anterior segment syndrome: common causes. J Cataract Refract Surg. 2010;36(7):1073-80.

Bodnar Z, Clouser S, Mamalis N. Toxic anterior segment syndrome: Update on the most common causes. J Cataract Refract Surg. 2012;38(11):1902-10.

Rose V. Keeping our eyes on TASS: our experience in the ambulatory care setting. Am J Infect Control. 2012;40(5):e149-50.

Kutty PK, Forster TS, Wood-Koob C, Thayer N, Nelson RB, Berke SJ, et al. Multistate outbreak of toxic anterior segment syndrome, 2005. J Cataract Refract Surg. 2008;34(4):585-90.

Clouser S. Toxic anterior segment syndrome: how one surgery center recognized and solved its problem. Insight. 2004;29(1):4-7.

Leder HA, Goodkin M, Buchen SY, Calogero D, Hilmantel G, Hitchins VM, et al. An investigation of enzymatic detergents as a potential cause of toxic anterior segment syndrome. Ophthalmology. 2012;119(7):e30-5.

Parikh C, Sippy BD, Martin DF, Edelhauser HF. Effects of enzymatic sterilization detergents on the corneal endothelium. Arch Ophthalmol. 2002;120(2):165-72.

Calogero D, Buchen SY, Tarver ME, Hilmantel G, Lucas AD, Eydelman MB. Evaluation of intraocular reactivity to metallic and ethylene oxide contaminants of medical devices in a rabbit model. Ophthalmology. 2012;119(7):e36-42.

Buchen SY, Calogero D, Hilmantel G, Eydelman MB. Rabbit ocular reactivity to bacterial endotoxin contained in aqueous solution and ophthalmic viscosurgical devices. Ophthalmology. 2012;119(7):e4-10.

Sakimoto A, Sawa M, Oshida T, Sugaya S, Hirono T, Ishimori A. Minimum endotoxin concentration causing inflammation in the anterior segment of rabbit eyes. Jpn J Ophthalmol. 2009;53(4):425-32.

Food and Drug Administration (FDA). Endotoxin testing recommendations for single-use intraocular ophthalmic devices - draft guidance for industry and food and drug administration staff. [cited 2014 Aug 10]. Available from: http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm393374.htm

Mathys KC, Cohen KL, Bagnell CR. Identification of unknown intraocular material after cataract surgery: evaluation of a potential cause of toxic anterior segment syndrome. J Cataract Refract Surg. 2008;34(3):465-9.

Tamashiro NS, Souza RQ, Goncalves CR, Ikeda TI, Luz RA, Cruz AS, et al. Cytotoxicity of cannulas for ophthalmic surgery after cleaning and sterilization: Evaluation of the use of enzymatic detergent to remove residual ophthalmic viscosurgical device material. J Cataract Refract Surg. 2013;39(6):937-41.

Chen KH, Lin SY, Li MJ, Cheng WT. Retained antibiotic ophthalmic ointment on an intraocular lens 34 months after. Am J Ophthalmol. 2005;139(4):743-5.

Wong JG, Bank A. Surgical removal of intraocular antibiotic ointment after routine cataract phacoemulsification. J Cataract Refract Surg. 2006;32(5):890-2.

Humayun M, Gottlieb CC, Rafuse PE. Intraocular ophthalmic ointment following clear corneal phacoemulsification. J Cataract Refract Surg. 2006;32(12):2135-8.

Kim SY, Park YH, Kim HS, Lee YC. Bilateral toxic anterior segment syndrome after cataract surgery. Can J Ophthalmol. 2007;42(3):490-1.

Conner RL. Toxic anterior segment syndrome; US Food and Drug Administration product and device clearance. AORN journal. 2006;84(5):841-7.

Hellinger WC, Bacalis LP, Edelhauser HF, Mamalis N, Milstein B, Masket S. Recommended practices for cleaning and sterilizing intraocular surgical instruments. J Cataract Refract Surg. 2007;33(6):1095-100.

Clouser S. TASS prevention for perioperative nurses. Perioper Nurs Clin. 2010;5(3):397-9.

Burlew JA. Care and handling or ophthalmic microsurgical instruments. 2nd ed. Iowa: KENDALL; 2005. 53 p.

Brasil. Agência Nacional de Vigilância Sanitária (ANVISA). RDC Nº15 de 15 de março de 2012. Dispõe sobre requisitos de boas práticas para o processamento de produtos para saúde e dá outras providências. DOU Nº 54, de 19 de março de 2012. Seção 1, p. 43- 46.

Delyfer MN, Rougier MB, Leoni S, Zhang Q, Dalbon F, Colin J, et al. Ocular toxicity after intracameral injection of very high doses of cefuroxime during cataract surgery. J Cataract Refract Surg. 2011;37(2):271-8.

Johnston J. Toxic anterior segment syndrome - more than sterility meets the eye. AORN J. 2006;84(6):967-84.

Eydelman MB, Tarver ME, Calogero D, Buchen SY, Alexander KY. The Food and Drug Administration’s proactive toxic anterior segment syndrome program. Ophthalmology. 2012;119(7):1297- 302.

Doshi RR, Arevalo JF, Flynn Jr. HW, Cunningham Jr. ET. Evaluating exaggerated, prolonged, or delayed postoperative intraocular inflammation. Am J Ophthalmol. 2010;150(3):295- 304.e1.

Luz RA, Padoveze MC, Cvintal T. Epidemiologic surveillance of postoperative endophthalmitis in a specialized ophthalmologic center in São Paulo, Brazil. Am J Infect Control. 2012;40(1):e1-3.

Publicado

2015-06-01

Como Citar

Luz, R. A., Padoveze, M. C., Souza, R. Q. de, Graziano, K. U., & Cvintal, T. (2015). Síndrome tóxica do segmento anterior após cirurgias de catarata: implicações para a enfermagem. Revista SOBECC, 20(2), 96–103. https://doi.org/10.5327/Z1414-4425201500020005

Edição

Seção

Artigos de Revisão