Incidence of toxic anterior segment syndrome and endophthalmitis in 190 000 eyes in a high-volume, multisurgeon, national network of ambulatory surgical centers using uniform perioperative protocols
Bibliographic record
Abstract
Plain Language Summary Toxic anterior segment syndrome (TASS) and postoperative endophthalmitis are rare but serious complications of intraocular surgery. Real-world incidence data from high-volume ambulatory surgical centers (ASCs) remain limited. We retrospectively analyzed 190,005 consecutive eyes undergoing cataract surgery or refractive lens exchange between January 2022 and April 2025 across 54 ASC sites. All cases were performed by 172 surgeons using standardized perioperative and sterilization protocols. Suspected TASS and endophthalmitis events were independently validated and centrally reviewed. Ten TASS cases were identified (0.0053%; 95% CI, 0.0029–0.0097%), including one bilateral case, all resolving with topical corticosteroids. Three endophthalmitis cases occurred (0.0016%; 95% CI, 0.0005–0.0046%), each managed successfully with intravitreal antibiotics and vitrectomy as indicated. No clustering was observed. The incidence of TASS and endophthalmitis in this national ASC network was markedly lower than reported in hospital-based studies. These findings support the safety of standardized high-volume ASC environments, including immediate sequential bilateral surgery. Plain Language SummaryThis study looked at the occurrence of two rare complications, TASS and endophthalmitis, after eye surgeries in high-volume ambulatory surgical centers (ASCs). Researchers analyzed data from 190,005 surgeries performed by 172 surgeons across 54 ASCs. They found 10 cases of TASS (0.0053%) and 3 cases of endophthalmitis (0.0016%), all successfully treated. The rates were lower than those reported in hospital settings, suggesting that standardized procedures in ASCs are safe and effective. This supports the use of ASCs for high-volume surgeries, including immediate sequential bilateral operations, due to their low complication rates. Text is machine generated and may contain inaccuracies. FAQ
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".