Incidence of intra-operative floppy iris syndrome in a UK district general hospital and implications for future workload

Amin, Khizer; Fong, Kenneth Choong Sian; Horgan, Simon

doi:10.1016/s1479-666x(08)80029-7

Cited by 17 publications

(8 citation statements)

References 6 publications

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“…1,9 More importantly, IFIS may increase the risk of major surgical complications such as posterior capsule rupture and vitreous loss when performed by expert surgeons (range, 0.0%-14.8%). 1,[3][4][5][6][7]9,16,[20][21][22][23] The tamsulosin-associated complication rates for cataract surgery performed by residents are unknown. Given the more challenging nature of tamsulosin cases and potential for increased complication risk, one may question whether resident surgeons should perform phacoemulsification on these patients.…”

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confidence: 99%

Resident-Performed Phacoemulsification Surgery in Tamsulosin-Treated Patients

Ku¹

2010

Arch Ophthalmol

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To compare intraoperative complication rates and visual outcomes for patients treated and not treated with tamsulosin hydrochloride who underwent resident-performed phacoemulsification, and to determine whether the recognition of intraoperative floppy iris syndrome in 2005 affected the subsequent complication rates for tamsulosin-treated patients. Methods: This comparative retrospective cohort study included 101 tamsulosin-treated eyes and 404 nontamsulosin-treated eyes from January 1, 1998, to August 31, 2008. Main outcome measures were major and minor complication rates and postoperative bestcorrected visual acuity. Complication rates were compared between

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confidence: 99%

Resident-Performed Phacoemulsification Surgery in Tamsulosin-Treated Patients

Ku¹

2010

Arch Ophthalmol

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“…Of the nine cases (5%) that didn't achieve this level of vision improvement, the cause was deemed to be amblyopia in one case, an epiretinal membrane in two cases, and age-related macular degeneration in the six remaining cases. Another study showed that posterior capsular rupture occurred in 1 of 23 (4%) cases and iris trauma occurred in 5 of 23 (22%) cases [72]. A bestcorrected visual acuity of 6/9 or better was achieved in 21 of 23 (91%) cases.…”

Section: Complications and Final Visual Outcomesmentioning

confidence: 96%

Alpha-Blockers and Intraoperative Floppy Iris Syndrome: Ophthalmic Adverse Events Following Cataract Surgery

Alhussaini

McVary

2010

Curr Urol Rep

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Intraoperative floppy iris syndrome (IFIS) is a triad of progressive intraoperative miosis despite preoperative dilation, billowing of a flaccid iris, and iris prolapse toward the incision sites during phacoemulsification surgery for cataract removal. IFIS has been associated with systemic alpha(1)-adrenergic receptor antagonists and other classes of medications for benign prostatic hyperplasia, as well as other systemic disease. The condition is best managed with several surgical and pharmacologic options if anticipated prior to surgery. Such precautions result in excellent surgical and visual acuity outcomes that appear similar to non-IFIS-affected eyes. There is still much to learn about IFIS and its exact causes, as well as a need for agreed upon guidelines that would enable physicians to properly anticipate and successfully manage or even prevent the condition.

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“…133 Although the incidence in the general population is low, it may reach high rates (50% to 60%) in patients who are or were treated with tamsulosin or other a-receptor antagonists such as alfuzosin or doxazosin used in the treatment of benign prostate hypertrophy. [133][134][135][136][137][138][139] Intraoperative floppy-iris syndrome is believed to result from the long-term inhibition of the iris dilator by a-antagonists, which leads to dilator atrophy 132,140,141 and explains why IFIS may occur years after tamsulosin use. Significant risk for IFIS was recently associated with the preoperative use of both selective and nonselective oral aantagonists, 142 but IFIS occurs more frequently with tamsulosin than with other a-antagonists.…”

Section: Intraoperativementioning

confidence: 99%