What does floppy iris mean?
The intra-operative floppy iris syndrome (IFIS) is a variant of the small pupil syndrome. It has been observed during cataract surgery in some patients currently or previously treated with the αl adrenoceptor (AR) antagonist tamsulosin. IFIS was first described by Chang et al.
Does Floppy iris affect vision?
The iris can also slip out of its normal position during surgery, making it even harder for the ophthalmologist to remove the old lens and insert a new one. This condition, dubbed floppy iris syndrome, increases the chance of complications, including vision loss.
What medications cause floppy iris syndrome?
The list of drugs associated with intraoperative floppy iris syndrome:
- Alfuzosin.
- Chlorpromazine.
- Donepezil.
- Doxazosin.
- Finasteride.
- Labetolol Hydrochloride.
- Mianserin.
- Prazosin.
How do you prevent floppy iris?
To prevent IFIS and its signs, Samuel Masket described pre-medicating at-risk patients with topical atropine sulfate 1% three times a day for two days before surgery, standard mydriatics and intraoperative intracameral epinephrine, attributing success in 19/20 eyes to synergy between the pupillary block provided by …
Why is my iris floppy?
IFIS is characterized by a triad of factors: a flaccid or floppy iris that billows in response to normal irrigation current in the anterior chamber during the standard phacoemulsification cataract surgery; a marked propensity for the iris to prolapse in the main phacoemulsification and side-port surgical incisions in …
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).
Does tamsulosin cause floppy iris syndrome?
Intraoperative floppy iris syndrome has most commonly been associated with tamsulosin, a selective alpha1 adrenergic antagonist used for relief of lower urinary tract symptoms associated with benign prostatic hypertrophy. The syndrome is nine times more prevalent in males.
What is the side effect of tamsulosin?
Dizziness, lightheadedness, drowsiness, runny/stuffy nose, or ejaculation problems may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.
How do you treat IFIS?
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.
Can tamsulosin affect your eyes?
Tamsulosin and other alpha-blockers may impede pupil dilation and cause the “IFIS triad” (a flaccid and billowing iris, iris prolapse through the surgical incisions and progressive intraoperative pupil constriction). This triad can potentially result in complications, such as iris trauma and posterior capsule rupture.
What medications should be stopped before cataract surgery?
Aspirin or non-steroidal “aspirin-like” products prevent blood from clotting properly. Taking these medications can cause excessive bruising and swelling. Medications which contain aspirin or “aspirin-like” products must be discontinued ten days prior to surgery.
What is floppy iris syndrome and what causes it?
Floppy iris syndrome is not a condition on its own. Instead, it is considered a complication. The complication can develop as a result of surgery that removes cataracts. The first case of floppy iris syndrome was reported in the year 20053.
What is flaccid iris syndrome?
This syndrome is characterized by a flaccid iris which billows in response to ordinary intraocular fluid currents, a propensity for this floppy iris to prolapse towards the area of cataract extraction during surgery, and progressive intraoperative pupil constriction despite standard procedures to prevent this.
Can Flomax cause floppy iris syndrome?
Intraoperative floppy iris syndrome. IFIS has been associated with tamsulosin (e.g., Flomax), a medication widely prescribed for urinary symptoms associated with benign prostatic hyperplasia (BPH). Tamsulosin is a selective alpha blocker that works by relaxing the bladder and prostatic smooth muscle.
How is Iris floppiness identified during cataract surgery?
The iris floppiness is usually identified during the hydrodissection (injection of balanced salt solution between the natural lens layers and the capsule to loosen the lens within the capsular bag) and phacoemulsification steps of the cataract extraction.
