Risk factors for intraoperative floppy iris syndrome: a retrospective study

Chatziralli, Irini; Sergentanis, Theodoros N.; Papazisis, Leonidas; Moschos, Marilita M.

doi:10.1111/j.1755-3768.2011.02132.x

Cited by 16 publications

(18 citation statements)

References 5 publications

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“…9,25 Interestingly, the observation on quetiapine, which is an antipsychotic agent, can be analogous to that of chloropromazine, attributing the effects of both medications to a1-adrenergic antagonism. 22,34 Moreover, hypertension was another positively associated factor with IFIS, a finding that has been also emerged at previous studies 31 and our previous metaanalysis on the field.…”

Section: Discussionmentioning

confidence: 99%

“…32 Another interesting finding of our study was the positive association between benzodiazepine use and IFIS, which confirmed the results of our previous retrospective study in a different population. 9 The mechanism by which benzodiazepines were associated with IFIS remains elusive, although we hypothesized that a biochemical link may exist. In fact, it has been shown that benzodiazepine receptors are present in various regions of the eye, including the ciliary body and specifically the iris, as well as in the retina and optic nerve.…”

Section: Discussionmentioning

confidence: 99%

“…33 Concerning finasteride, the evidence in the literature is relatively low, as there is only a retrospective study and two case reports dealing with the association between finasteride and IFIS. 9,18,19 It should be noted that in all these cases, the patients had never received tamsulosin or other α-blocker, suggesting that the effect of finasteride seems independent. The underlying mechanism remains unknown; therefore, experimental studies are needed to confirm this finding.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, several reports have been published, suggesting an association between IFIS and finasteride, 9,18,19 mianserin, 20 antipsychotic agents, 21 chloropromazine, 22,23 donepezil, 24 quetiapine, 9,25 imipramine, 26 risperidone, 27 duloxetine, 28 warfarin, 29 aspirin, 23 losartan, 23 and metformin. 23 Apart from potential association with the intake of various medications, IFIS has been also noted in patients with hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for intraoperative floppy iris syndrome: a prospective study

Chatziralli

Peponis

Parikakis

et al. 2016

Eye

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for intraoperative floppy iris syndrome: a prospective study

Chatziralli

Peponis

Parikakis

et al. 2016

Eye

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“…Although this syndrome is multifactorial, there is a strong association with the chronic use of a-receptor antagonists (Neff et al 2009), especially tamsulosin which is a selective a-1-AR antagonists (Chatziralli & Sergentanis 2011;Chatziralli et al 2012).…”

mentioning

confidence: 99%

Sub‐Tenon injection of 2% lidocaine prevents intra‐operative floppy iris syndrome (IFIS) in male patients taking oral α‐adrenergic antagonists

Kłysik

Korzycka²

2013

Acta Ophthalmologica

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a-adrenergic receptor antagonists are used to relax smooth muscle of the lower urinary tract, for relief of symptoms of benign prostatic hyperplasia. They cause pupil hypotony (Parssinen 2005) ABSTRACT.Purpose: To compare 2% sub-Tenon and 1% intra-cameral lidocaine for cataract surgery in relation to the incidence and severity of IFIS. Prospective randomized clinical study. Methods: From 81 eligible, we included 71 men aged from 59 to 90 years (mean 76.5 ± 6.8) undergoing routine cataract surgery and taking oral aadrenergic antagonists, for urological reasons, for more than 1 year. Following randomization 34 men, aged from 62 to 90 years (mean 77.4 ± 8.1) received sub-Tenon injection of 2.5 ml of 2% lidocaine and the remaining 37 men aged from 59 to 89 years (mean 75.2 ± 7.2) received 1% preservative free intracameral lidocaine. Outcome measures were the incidence of IFIS, severity of intra-operative pupillary constriction and iris prolapse.Results: Intra-operative floppy iris syndrome (IFIS) was noted in 3 of 34 patients (8.8%) receiving sub-Tenon lidocaine and in 18 of 37 patients (48.6%) receiving intra-cameral lidocaine (p = 0.00). Severe IFIS was observed only in 3 of 37 patients (8.1%) receiving intra-cameral lidocaine. Pupil diameter at the end of surgery was 4.37 ± 1.07 mm in the sub-Tenon lidocaine group and 4.02 ± 1.06 mm in the intra-cameral lidocaine group (p = 0.00). Iris prolapse was noted in two cases in the sub-Tenon lidocaine group and in 10 cases in the intra-cameral lidocaine group (p = 0.00). Twenty-five patients were receiving tamsulosin. The incidence of IFIS in tamsulosin subgroup was 76.9% (10 of 13 patients) in the intra-cameral lidocaine group and 16.6% (2 of 12 patients) in the sub-Tenon lidocaine group (p = 0.00). Conclusion: Sub-Tenon lidocaine reduces significantly the incidence of IFIS in patients taking oral a-adrenergic inhibitors as compared with intra-cameral lidocaine.

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