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Case Reports in Medicine
Volume 2014, Article ID 143564, 3 pages
Case Report

Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

1Department of Ophthalmology, Faculty of Medicine, Kafkas University, Merkez, 36100 Kars, Turkey
2Department of Ophthalmology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, 34865 Istanbul, Turkey
3Department of Ophthalmology, Hacettepe University Beytepe Health Center, 06800 Ankara, Turkey
4Department of Pathology, Dr. Lutfi Kirdar Kartal Education and Research Hospital, 34865 Istanbul, Turkey
5Kafkas University, 36100 Kars, Turkey

Received 3 July 2014; Accepted 30 October 2014; Published 10 December 2014

Academic Editor: Marco A. Zarbin

Copyright © 2014 Yaran Koban et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objective. To report a case of toxic anterior segment syndrome (TASS) that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL), which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber.