What causes intraoperative floppy iris syndrome?
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What causes intraoperative floppy iris syndrome?
Intraoperative floppy iris syndrome (IFIS) was first characterized by Chang and Campbell in 2005. It is associated with the use of systemic α-receptor blockers, such as tamsulosin (Flomax), used in the medical management of benign prostatic hyperplasia (BPH).
What is intraoperative floppy iris syndrome?
Intraoperative floppy iris syndrome (IFIS) is a recently described phenomenon affecting cataract surgery. It consists of poor preoperative pupil dilation together with progressive intraoperative pupil constriction, billowing of a flaccid iris stroma, and iris prolapse to the surgical incisions.
What causes floppy iris during cataract surgery?
The intraoperative floppy iris syndrome was first reported by Drs. David Chang and John Campbell in 2005. This major discovery showed that the most common prostate medications (such as Flomax) cause iris problems during cataract surgery that can lead to many complications if the surgeon does not anticipate them.
How can intraoperative floppy iris be prevented?
IFIS can be prevented and treated by maintaining mydriasis and restraining the iris from prolapsing during cataract surgery. This can be accomplished by mechanical and pharmacologic treatments and the use of intraoperative proper phacoemulsification fluidic parameters.
Why does tamsulosin cause floppy iris?
Alpha1 adrenergic antagonists relax smooth muscle, including that of the dilator muscle of the iris. However, the mechanism by which tamsulosin induces intraoperative floppy iris syndrome is likely to be more complex given the multiple signalling pathways in the iris.
Which medication can cause intraoperative floppy iris syndrome in cataract surgery patients?
The uroselective alpha-blocker tamsulosin is the most commonly used drug among all. Studies showed that the majority of the patients who develop intraoperative floppy iris syndrome (IFIS) were on tamsulosin.
Which drugs cause floppy iris syndrome?
The list of drugs associated with intraoperative floppy iris syndrome:
- Alfuzosin.
- Chlorpromazine.
- Donepezil.
- Doxazosin.
- Finasteride.
- Labetolol Hydrochloride.
- Mianserin.
- Prazosin.
