JCRS: 190,000 eyes TASS, endophthalmitis rates

Toxic anterior segment syndrome is a sterile chemical inflammation after eye surgery, while endophthalmitis is an infection inside the eye. A new JCRS report measured how often each happened across 190,005 lens procedures in Canada. (pmc.ncbi.nlm.nih.gov) (eyewiki.org) The analysis covered cataract surgery and refractive lens exchange performed from January 2022 through April 2025 at 54 ambulatory surgical centers. The network included 172 surgeons and 109,121 patients. (pmc.ncbi.nlm.nih.gov) Authors reported 10 toxic anterior segment syndrome cases, including one bilateral case, for an incidence of 0.0053%. They reported three endophthalmitis cases, or 0.0016%, with no clustering across centers. (pmc.ncbi.nlm.nih.gov) (researchsquare.com) The distinction matters because the timing is different. Toxic anterior segment syndrome usually appears within 12 to 48 hours and often responds quickly to topical steroids, while infectious endophthalmitis more often presents days later and can require intravitreal antibiotics or vitrectomy. (eyewiki.org) (pmc.ncbi.nlm.nih.gov) In this series, every toxic anterior segment syndrome case resolved with topical corticosteroids. The three endophthalmitis cases were managed with intravitreal antibiotics, with vitrectomy used when indicated. (pmc.ncbi.nlm.nih.gov) (researchsquare.com) The paper focused on ambulatory surgical centers using uniform perioperative protocols and centralized complication reporting. Each suspected case was validated by the surgeon and reviewed by the clinical director using consistent diagnostic criteria. (pmc.ncbi.nlm.nih.gov) That gives surgeons a benchmark from high-volume, nonhospital cataract centers, where large real-world incidence data have been limited. The authors described the dataset as the largest of its kind in Canada. (pmc.ncbi.nlm.nih.gov) The endophthalmitis rate in this report was below the 0.012% rate reported by Moorfields Eye Hospital for elective phacoemulsification cataract surgery between 2015 and 2022, and below older UK national audit figures of 0.03% from 2006 to 2010. Different settings and methods limit direct comparison. (nature.com) The paper’s closing point is operational, not theoretical: when rare complications are tracked the same way across dozens of sites, instrument reprocessing and postoperative triage can be audited against a real baseline. (pmc.ncbi.nlm.nih.gov)