tions or products, or from medication or instrument handling proce-
dures within the facilities.
"It's an ongoing issue," says Nick Mamalis, MD, one of the world's
foremost experts on TASS. "We're still getting phone calls or emails
regarding issues with TASS at a particular surgical center or hospital a
couple times a month. Most people don't pay attention to TASS, or its
causes, or prevention, until it actually happens to them."
Dr. Mamalis estimates the TASS reports he's received in the last year
to be in the hundreds, but says it's difficult to know how many cases
of TASS there are, because many aren't reported or diagnosed proper-
ly.
"It's vastly under-reported," says Jimmy K. Lee, MD, director of
cornea and refractive surgery at Montefiore Medical Center in Bronx,
N.Y., "especially in situations where it's a single occurrence or a small
number of cases spread among surgeons who do not operate on same
days and do not communicate regularly. It really doesn't trigger
awareness or attention until someone recognizes there's a cluster of
potential TASS cases."
2. New cleaning and sterilization guidelines.
Last April,
after 3 years of collaborative research, the American Society of
Cataract and Refractive Surgery (ASCRS), the American Academy of
Ophthalmology (AAO) and the Outpatient Ophthalmic Surgery Society
(OOSS) released ophthalmology-specific instrument cleaning and ster-
ilization guidelines. These were the first updates to the original guide-
lines in a decade.
Dr. Mamalis, co-chair of the task force that authored the guidelines
(osmag.net/XFmVe4), identifies insufficient instrument cleaning and
sterilization as the most common cause of TASS. The task force found
general surgery guidelines for instrument processing may be inappro-
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