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. 2021 Jul 18;14(7):1018-1024.
doi: 10.18240/ijo.2021.07.09. eCollection 2021.

Predictive value of pupillography on intraoperative floppy iris syndrome in preoperative period

Gozde Sahin Vural  1 , Mehmet Vural  2
Affiliations

Predictive value of pupillography on intraoperative floppy iris syndrome in preoperative period

Gozde Sahin Vural et al. Int J Ophthalmol. .

Abstract

Aim: To present the frequency of intraoperative floppy iris syndrome (IFIS) in cataract patients who taking alpha 1-a receptor antagonist (ARA) drugs, and evaluate the predictive value of pupil diameter (PD) changes in IFIS patients.

Methods: Male cataract patients who are under treatment with alpha-1a-ARAs (alfuzosin, tamsulosin) intraoperatively were evaluated and were grouped as with/without IFIS. The preoperative PD values were compared with controls. Also, the intraoperative manipulations and early/late complications were recorded.

Results: A total of 77 patients (77 eyes) of 94 benign prostate hyperplasia (BPH) patients have been defined as IFIS (81.91%) and 40 patients (40 eyes) were taking tamsulosin and 37 patients (37 eyes) were taking alfuzosin. During the cataract surgery, the rate of posterior capsular rupture (P=0.754), vitreous loss (P=0.585), iris tears (P=0.004), and iris catching (P=0.000) were higher in IFIS group, but the difference was significant only in the iris catching. At the postoperative first-month visit, persistent IOP rise and iris stromal tears were more frequent in IFIS group, but the difference was not significant (P=0.311, P=0.146; respectively). In contrast, Descemet membrane detachment was insignificantly more frequent in controls (P=0.311). In IFIS and control patients, PDs were 9.54±1.78 and 9.72±1.57 mm (P=0.255) under scotopic illumination, 8.54±1.43 and 8.74±1.25 mm (P=0.289) under mesopic illumination, 6.99±1.35 and 7.27±1.39 mm (P=0.662) under photopic illumination, respectively. However PDs were lower in IFIS under all illumination degrees, no significant difference was detected between groups.

Conclusion: IFIS is a significant clinical syndrome with an increased intraoperative/postoperative complication ratio. The prediction of this syndrome is important because of prevention required precautions against possible complications. There is no association between IFIS and preoperative PD.

Keywords: alpha-1 adrenergic receptor antagonists; cataract; intraoperative floppy iris syndrome; pupillography.

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References

    1. Chang DF, Campbell JR. Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg. 2005;31(4):664–673. - PubMed
    1. Chang DF, Braga-Mele R, Mamalis N, Masket S, Miller KM, Nichamin LD, Packard RB, Packer M. ASCRS White Paper: clinical review of intraoperative floppy-iris syndrome. J Cataract Refract Surg. 2008;34(12):2153–2162. - PubMed
    1. Schwinn DA, Afshari NA. α1-adrenergic antagonists and floppy iris syndrome: tip of the iceberg? Ophthalmology. 2005;112(12):2059–2060. - PubMed
    1. Gupta A, Srinivasan R. Floppy iris syndrome with oral imipramine: a case series. Indian J Ophthalmol. 2012;60(2):136–138. - PMC - PubMed
    1. Schwinn DA, Afshari NA. Alpha(1)-adrenergic receptor antagonists and the iris: new mechanistic insights into floppy iris syndrome. Surv Ophthalmol. 2006;51(5):501–512. - PubMed

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