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Floppy iris syndrome

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 comprised 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...
July 21, 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
Matthias Oelke, Adrian Gericke, Martin C Michel
INTRODUCTION: α1-Adrenoceptor antagonists (α-blockers) represent first-line drug treatment for male lower urinary tract symptoms. Their adverse events (AEs) include asthenia, dizziness, nasal congestion, arterial (orthostatic) hypotension and intraoperative floppy iris syndrome (IFIS). AREAS COVERED: This report focuses on cardiovascular and ocular AEs of α-blockers as related to their mechanism of action and subtype selectivity. EXPERT OPINION: The incidence of hypotension differs between α-blockers...
September 2014: Expert Opinion on Drug Safety
Faruquz Zaman, Christian Bach, Islam Junaid, Athanasios G Papatsoris, Jhumur Pati, Junaid Masood, Noor Buchholz
INTRODUCTION: Benign prostatic hyperplasia (BPH) and cataract formation are common in older people. Medical management of symptomatic BPH is often preferred to surgical treatment as surgery increases the risk of morbidities, whereas, surgery is the main form of treatment to restore sight in patient with cataract. The clinical treatment of BPH is either alpha-1 adrenergic antagonist alone or combination of alpha reductase inhibitor and alpha adrenergic receptor (AR) antagonist. There are four alpha-AR antagonists currently available to treat BPH...
May 2012: Current Urology
Roni M Shtein, Munira T Hussain, Theresa M Cooney, Victor M Elner, Christopher T Hood
PURPOSE: To determine whether preoperative iris vasculature and morphology are altered in patients who have taken tamsulosin (Flomax). SETTING: Academic multispecialty practice. DESIGN: Case series. METHODS: Patients with current or past tamsulosin use and age- and sex-matched control patients were included. Anterior segment optical coherence tomography (AS-OCT) and iris fluorescein angiography were performed to measure iris vasculature and thickness before cataract surgery...
May 2014: Journal of Cataract and Refractive Surgery
Slawomir Jan Teper, Dariusz Dobrowolski, Edward Wylegala
The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH...
2011: Central European Journal of Urology
Ming Chen, Kara C Lamattina, Thomas Patrianakos, Surendar Dwarakanathan
PURPOSE: To compare the complication rate of posterior capsule rupture (PCR) with vitreous loss during phacoemulsification at an ambulatory surgical center with published results as a clinical audit for quality control. METHODS: A retrospective chart review of 3,339 consecutive patients who underwent routine phacoemulsification by four experienced private practice surgeons from January 1, 2011 to June 30, 2012 at The Surgical Suites, Honolulu, HI, USA. All cases with PCR and vitreous loss were identified and selected for the study...
2014: Clinical Ophthalmology
Dong Hui Lim, Min Gyu Lee, Tae-Young Chung, Eui-Sang Chung
PURPOSE: To evaluate the incidence and clinical manifestations of intraoperative floppy iris syndrome (IFIS) according to iris alterations in Korean patients taking α1-adrenergic receptor antagonists (α1-ARAs). METHODS: This is a prospective observational study. Two surgeons performed cataract surgery in 758 eyes of 596 patients over a period of 12 months. Past medical history was reviewed, especially whether patients had been taking systemic α1-ARAs. Ultrasound biomicroscopy was performed to measure the iris thickness of the dilator muscle region (DMR) at half the distance between the scleral spur and the pupillary margin...
April 2014: British Journal of Ophthalmology
Cristina Nicula, D Nicula, Raluca Popescu
PURPOSE: is to evaluate the incidence and typical signs of floppy iris syndrome intraoperatory revealed in patients diagnosed with cataracts. METHODS: We studied a total of 15 eyes diagnosed with cataracts, belonging to 14 patients who had been treated chronically with Tamsulosin for benign prostatic hyperplasia. RESULTS: In 80% of cases we have seen a preoperative semimidriasis which required iris hooks in 5 eyeballs. On 1 eye preoperative semimidriasis was sufficient for capsulorhexis, but later pupil became miotic, requiring iris hooks...
2013: Oftalmologia
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