Aseptic Techniques & Infection Control Flashcards

A patient has diffuse limbus-to-limbus corneal edema and anterior chamber inflammation 18 hours after an uneventful cataract surgery, with little pain. Which condition is most likely?

Answer: Toxic anterior segment syndrome (TASS)

TASS usually appears within 12-48 hours as sterile anterior inflammation with diffuse corneal edema.

Which of the following is a recognized cause of TASS linked to instrument reprocessing?

Answer: Residual enzymatic detergent left on instruments

Detergent residue, endotoxins, and denatured viscoelastic left in instruments are classic causes of TASS.

What is the most common source of organisms causing postoperative endophthalmitis?

Answer: The patient's own eyelid and conjunctival flora

Most cases come from the patient's periocular flora, especially coagulase-negative staphylococci.

Which preoperative measure has the strongest evidence for lowering the risk of endophthalmitis after intraocular surgery?

Answer: Topical povidone-iodine 5% in the conjunctival sac

Applying povidone-iodine 5% to the ocular surface is the best-supported antiseptic prophylaxis.

A patient reports a shellfish allergy before ophthalmic surgery. What does this mean for povidone-iodine prep?

Answer: It is not a true contraindication to povidone-iodine

Shellfish allergy is not cross-reactive with povidone-iodine, so the prep is generally still appropriate.

What is the main purpose of the adhesive plastic drape in eye surgery?

Answer: To isolate the eyelashes and lid margins from the surgical field

Tucking the lashes and lid margins under the adhesive drape keeps their bacterial flora away from the incision.

Per ASCRS reprocessing guidance, what should be used to flush and rinse lumened intraocular instruments such as I/A tips?

Answer: Sterile or deionized water

Sterile or deionized water rinsing removes debris without leaving the minerals and endotoxins linked to TASS.