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Floppy iris syndrome

Tamar Pedut Kloizman, Raneen Shehadeh Mashour
Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell in 2005. The characteristics of this syndrome include: 1. Floppy iris that billows in reaction to intraocular fluid currents during standard phacoemulsification procedure; 2. Flaccid iris stroma that tends to prolapse through well-constructed surgical incisions; 3. Insufficient pupillary mydriasis despite proper pharmacologic preparation and progressive pupillary constriction during the operation. Surgical procedures with IFIS have since been noted to have an exceptionally high rate of complications, some of which can be vision threatening...
September 2016: Harefuah
M Tsatsos, C MacGregor, I Athanasiadis, M Moschos, A Mataftsi, N Ziakas
No abstract text is available yet for this article.
June 2017: Eye
David S Wang
No abstract text is available yet for this article.
March 2017: Journal of Urology
Joao Crispim, Wallace Chamon
According to the World Health Organization, cataract is the major cause of reversible visual impairment in the world. It is present as the cause of decreased visual acuity in 33% of the visual impaired citizens. With the increase of life expectancy in the last decades, the number of patients with cataract is expected to grow for the next 20 years. Nowadays, the only effective treatment for cataracts is surgery and its surgical outcomes have been increasingly satisfactory with the technological advancement...
2017: Handbook of Experimental Pharmacology
Pornchai Simaroj, Kaevalin Lekhanont, Puwat Charukamnoetkanok
Purpose. To report a modified surgical strategy in the management of intraoperative floppy iris syndrome-associated iris prolapse. Methods. Prolapsed iris is left as is and a new corneal incision near the original wound but at a different site is created. Depending on the location of the original incision and the surgeon's preference, this additional incision can be used as a new port for phacoemulsification tip or can be the new site for the iris to securely prolapse, allowing for the surgery to proceed safely...
2016: Case Reports in Ophthalmological Medicine
Manpreet Kaur, Jeewan S Titiyal, Ruchita Falera, Tarun Arora, Namrata Sharma
PURPOSE: To evaluate the visual and anatomical outcomes of Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with toxic anterior segment syndrome (TASS). METHODS: Fourteen eyes of 14 patients who underwent clear corneal DSAEK for endothelial decompensation secondary to TASS after phacoemulsification were included in this prospective study. Intraoperative surgical difficulties were noted. Preoperative and postoperative evaluation of visual acuity, slit-lamp examination, intraocular pressure, central corneal thickness, and endothelial count was performed in all cases...
January 2017: Cornea
Michael Wahl, Saskia M Tipotsch-Maca, Pia V Vecsei-Marlovits
PURPOSE: To evaluate the association between intraoperative floppy iris syndrome (IFIS) and concurrent medications containing selective alpha1A receptor antagonists as well as nonselective alpha1-adrenergic receptor antagonists, bulbus length, patient age and gender. METHODS: We performed a prospective data acquisition of IFIS occurrence and grading, and retrospective evaluation of concurrent medications, bulbus length, patient age and gender of all patients undergoing cataract surgery over a 6-month period...
January 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
Richard S Koplin, David C Ritterband, Jack M Dodick, Eric D Donnenfeld, Mark Schafer
PURPOSE: To determine the relationship between untoward events noted during phacoemulsification surgery associated with aberrant infusion misdirection and their causal relationship to current infusion sleeve design. SETTING: The New York Eye & Ear Infirmary of Mt. Sinai, New York, New York, USA. DESIGN: Retrospective case reports and experimental study. METHODS: Observations of live cataract surgery were documented with high-definition videography using 3 commercial phacoemulsification platforms...
August 2016: Journal of Cataract and Refractive Surgery
Masato Matsuo, Ichiya Sano, Yoshifumi Ikeda, Etsuko Fujihara, Masaki Tanito
OBJECTIVE: We report 3 cases of intraoperative floppy-iris syndrome (IFIS) during cataract surgery in patients without a history of selective α1-blocker use but with a long-term history of antipsychotic drug use. We reviewed previously reported cases of antipsychotic drug-associated IFIS cases. DESIGN: Observational case series. RESULTS: In case 1, bilateral IFIS developed in a 39-year-old man with chronic angle-closure glaucoma. He had used several classes of antipsychotic drugs to treat schizophrenia, including the first-generation antipsychotic drugs haloperidol and chlorpromazine, the dopamine system stabilizer aripiprazole, the dopamine serotonin antagonists olanzapine and quetiapine, and the serotonin dopamine antagonists risperidone and blonanserin for 7 years...
August 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Youning Zhang, Neda Shamie, Siamak Daneshmand
OBJECTIVES: To assess urologists' awareness of intraoperative floppy iris syndrome. MATERIALS AND METHODS: A questionnaire composed of 21 questions was emailed to all of the Urology residency programs in the U.S. and all members of the Western section of the American Urological Association. Responses were collected and analyzed using statistical software. RESULTS: A total of 175 responses were collected from residents, fellows, and attending physicians from a wide range of geographic locations, subspecialties, and practice settings...
November 2016: Urology
I P Chatziralli, V Peponis, E Parikakis, A Maniatea, E Patsea, P Mitropoulos
PurposeTo evaluate risk factors for intraoperative floppy iris syndrome (IFIS) in patients undergoing phacoemulsification.MethodsParticipants in the study were 1274 consecutive patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors: ophthalmological conditions, axial length of the eye, sociodemographic features, clinical data (hypertension and diabetes mellitus), medications being taken at the time of surgery, and duration of their intake...
August 2016: Eye
Sharon Armarnik, Michael Mimouni, Eli Rosen, Ehud I Assia, Fani Segev
BACKGROUND: We aimed to report a simple technique that involves modified anterior (to the limbus) elongated corneal incisions in order to reduce the incidence and severity of intraoperative floppy iris syndrome (IFIS) and related complications. METHODS: This was a retrospective study of phacoemulsification cataract surgeries performed by a single surgeon on patients receiving tamsulosin or alfuzosin between 1 January 2009 and 31 July 2012 at Meir Medical Center, Kfar-Sava, Israel...
January 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
K Horvath, F Vultur, V Simon, S Voidazan, Gh Mühlfay
AIM: The purpose of this study was to investigate intraoperative iris behavior during some phacoemulsification maneuvers in rabbits treated with tamsulosin or finasteride. MATERIAL AND METHOD: An experimental study was conducted on 26 Metis male rabbits aged 1.5 - 2 years, body weight between 3.4 and 5.6 kg, divided into three groups: Group 1 - Control, 6 rabbits; Group 2 - tamsulosin, 10 rabbits; Group 3 - finasteride, 10 rabbits. Dose calculation was performed according to body surface area ratio man/rabbit, taking into account the median lethal dose LD50...
January 2015: Hippokratia
V Fenicia, S Abdolrahimzadeh, G Scuderi, L Fabrizio, M Maurizi Enrici, F Cruciani, S M Recupero
OBJECTIVE: Intracameral mydriatics using epinephrine associated with lidocaine have been reported as efficacious in reducing intraoperative floppy iris syndrome (IFIS) complications during cataract surgery. The aim of this study was to verify the efficacy of intracameral epinephrine without intracameral lidocaine as prophylaxis against IFIS in patients on tamsulosin. MATERIALS AND METHODS: This was a retrospective study on the results of cataract surgery in 18 patients on therapy with tamsulosin...
2015: La Clinica Terapeutica
Steven A Kaplan
No abstract text is available yet for this article.
March 2015: Journal of Urology
J González-Martín-Moro, J J González-López, J Zarallo-Gallardo, Y Fernández-Miguel
CASE REPORT: The case is presented of a severe Intraoperative Floppy Iris Syndrome (IFIS) in a patient that had been treated with duloxetine. DISCUSSION: Tamsulosin is the main etiological agent involved in IFIS. However several cases of IFIS, supposedly secondary to drugs of different groups have recently been reported in the literature. The authors use this case report as a means to discuss why most of these cases should be considered anecdotal evidence.
February 2015: Archivos de la Sociedad Española de Oftalmología
Marcin L Kordasz, Caroline Manicam, Andreas Steege, Evgeny Goloborodko, Claudia Amato, Panagiotis Laspas, Christoph Brochhausen, Norbert Pfeiffer, Adrian Gericke
PURPOSE: The α₁A-adrenoceptor (α₁A-AR) subtype was suggested to mediate contraction and trophic effects in the iris dilator muscle, and thus its pharmacological blockade may be involved in intraoperative floppy iris syndrome. We tested the hypothesis that the α₁A-AR mediates pupil dilation and trophic effects in the mouse iris. METHODS: The α₁-AR subtype mRNA expression was quantified in iris tissue by real-time PCR. To assess the role of individual α₁-ARs for mediating pupil dilation, the α₁-AR agonist phenylephrine was topically applied to the ocular surface of mice deficient in one of the three α₁-AR subtypes (α₁A-AR(-/-), α₁B-AR(-/-), α₁D-AR(-/-), respectively) and wild-type controls...
December 2014: Investigative Ophthalmology & Visual Science
Ovidiu Muşat, Labib Mahdi, Andreea Gheorghe, Marian Burcea, Corina Cernat, Răzvan Cristescu, Oana Toma, Asandi Radu
Small pupil and Intraoperative Floppy Iris Syndrome (lFIS) has always been a challenge in cataract surgery. Iris dilation and mechanical stabilization can be achieved by using intraoperative iris retractors, preferably before capsulorhexis. Malyugin ring is a mechanical iris expansion device, which presents many advantages (gently relaxes the iris tissue, implants easier and less traumatic). The disadvantages of using Malyugin ring consists primarily in the high cost and in an increased duration of surgical procedure...
2014: Oftalmologia
Shilpa Goyal, Deepansh Dalela, Neeraj Kumar Goyal, Shobhit Chawla, Rajat Dhesi, Bela Kamboj, Abha Dalela
PURPOSE: The purpose of this study was to evaluate the incidence, risk factors, and impact of intraoperative floppy iris syndrome (IFIS) on surgical performance. MATERIALS AND METHODS: Consecutive cataract surgeries from October 2010 to Feb 2011 (1003 eyes, 980 patients; 568 males, 412 females) were analyzed prospectively. Operating surgeon, masked about medication history, noted the intraoperative details. Cases were identified as IFIS or non-IFIS. Multivariate analysis was performed to find risk factors for IFIS...
August 2014: Indian Journal of Ophthalmology
Mahavir Singh Griwan, Y R Karthikeyan, Mandeep Kumar, Bikram Jit Singh, Santosh Kumar Singh
INTRODUCTION: Naftopidil, approved initially in Japan, is an α1d-adrenergic receptor antagonist (α1-blocker) used to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). It is different from tamsulosin hydrochloride and silodosin, in that it has a higher affinity for the α1D-adrenergic receptor subtype than for the α1A subtype and has a superior efficacy to a placebo and comparable efficacy to other α1-blockers such as tamsulosin. The incidences of ejaculatory disorders and intraoperative floppy iris syndrome induced by naftopidil may also be lower than that for tamsulosin and silodosin, which have a high affinity for the α1A-adrenergic receptor subtype...
July 2014: Urology Annals
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