Toxic anterior segment syndrome prevention: A clinical audit cycle

Purpose: The purpose of this study was to evaluate and improve adherence to sterilization and disinfection protocols aimed at preventing toxic anterior segment syndrome (TASS) following cataract surgery in a South Indian hospital. This study was designed to audit our own department’s understanding and practice with respect to sterilization practices. Materials and Methods: A pre–post interventional audit was conducted among the operating theater (OT) staff. A baseline evaluation of sterilization practices and staff knowledge was carried out using a structured questionnaire and observation checklist. Following the initial audit, the hospital audit committee evaluated the results; thereafter, concerned staff was educated with interventions including staff education seminars, random OT inspections, introduction of lint-free mats, discontinuation of preserved epinephrine, and strict monitoring of instrument cleaning. Postintervention assessment of practices and TASS incidence was performed over subsequent months. A statistically significant improvement was found in the second audit cycle. Results: The baseline incidence of TASS was 1.99%–2.25% (3–4 cases/month). Following interventions, incidence decreased to 1.35%, 0.8%, and eventually 0% over the next two quarters. Documented adherence to suggested cleaning, sterilization, and inspection procedures demonstrated a notable improvement in sterilization standards compliance. Conclusions: TASS incidence was successfully decreased in our setup through regular clinical audits, education, and quality control procedures. Maintaining patient safety during cataract surgery requires regular re-audits and protocol reinforcement.