Intraoperative floppy iris syndrome in a patient taking alfuzosin for benign prostatic hypertrophy

Pharmacologic pupil dilation as a predictive test for the risk for intraoperative floppy-iris syndrome

“…11,12 The association between tamsulosin and IFIS has been confirmed in numerous studies, 5,[13][14][15] as has the fact that IFIS may occur in patients taking other a 1 -ARAs. 11,13,[16][17][18][19][20] In the 2008 American Society of Cataract and Refractive Surgery (ASCRS) IFIS survey, 21 95% of experienced surgeons reported that systemic treatment with the a 1 -ARA tamsulosin makes cataract surgery more difficult and leads to higher rates of complications. Therefore, it would be helpful to predict preoperatively which patients are at risk.…”

Pathophysiology and Pre-Operative Evaluation of Patients at Risk for Intraoperative Floppy Iris Syndrome (IFIS)

“…Blockade of this muscle's 1 AR is hypothesized to lead to poor muscle tone and the subsequent iris billowing sometimes seen in cataract surgery (Schwinn & Afshari, 2006). (Dhingra et al, 2007;Herd, 2007;Package insert Rapaflo, 2008;Settas & Fitt, 2006;Venkatesh et al, 2007).…”

“…Following the original report suggesting a stronger link between tamsulosin and IFIS relative to other 1 AR antagonists, subsequent case reports of IFIS have been published in men taking alfuzosin, doxazosin, and terazosin (Dhingra et al, 2007;Herd, 2007;Settas & Fitt, 2006;Venkatesh et al, 2007). Aside from IFIS, 1 AR antagonist therapy prior to cataract surgery has been shown to predispose patients to complications following cataract surgery (Bell et al, 2009).…”

Intraoperative floppy iris syndrome associated with silodosin

“…The rate of IFIS with tamsulosin was 60% in literature (Michel et al 2006;Settas & Fitt 2006). Michel et al (2006) reported IFIS with other alpha blockers in rabbits.…”