Enzymatic Detergents and Toxic Anterior Segment Syndrome

We read with interest the article by Leder et al entitled “An Investigation of Enzymatic Detergents as a Potential Cause of Toxic Anterior Segment Syndrome.” The authors investigated whether enzymatic detergents used in the cleaning of ophthalmic instruments can cause toxic anterior segment syndrome (TASS) in a rabbit model. They concluded that their results do not support residual enzyme detergents as a cause of TASS. We would like to raise some concerns regarding the authors' interpretation of the data and their conclusions.

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