Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan;262(1):103-111.
doi: 10.1007/s00417-023-06165-3. Epub 2023 Jul 10.

Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome

Karin Paschon  1   2   3   4 , Stephan Szegedi  1   2 , Birgit Weingessel  1   2 , Klemens Fondi  2 , Wolfgang Huf  5 , Pia Veronika Vécsei-Marlovits  1   2
Affiliations

Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome

Karin Paschon et al. Graefes Arch Clin Exp Ophthalmol. 2024 Jan.

Abstract

Purpose: To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery.

Methods: Prospective cohort study of 55 patients with α1-adrenergic receptor antagonist (α1-ARA) treatment and 55 controls undergoing cataract surgery. Anterior segment optical coherence tomography (AS-OCT), video pupilometer, and biometry measurements were performed preoperatively and analyzed regarding anatomic parameters that corresponded with a higher rate of IFIS. Those statistically significant parameters were evaluated with logistic regression analysis and receiver operating characteristic (ROC) curve.

Results: Pupil diameter was significantly smaller in patients who developed IFIS compared to those who did not develop IFIS (AS-OCT 3.29 ± 0.85 vs. 3.63 ± 0.68, p = 0.03; Pupilometer 3.56 ± 0,87 vs. 3.95 ± 0.67, p = 0.02). Biometric evaluation revealed shallower anterior chambers in the IFIS group (ACD 3.12 ± 0.40 vs. 3.32 ± 0.42, p = 0.02). Cutoff values for 50% IFIS probability (p = 0.5) were PD = 3.18 mm for pupil diameter and ACD = 2.93 mm for anterior chamber depth. ROC curves of combined parameters were calculated for α1-ARA medication with pupil diameter and anterior chamber depth, which yielded an AUC of 0.75 for all IFIS grades.

Conclusion: The combination of biometric parameters with history of α1-ARA medication can improve assessment of risk stratification for IFIS incidence during cataract surgery.

Keywords: Biometry; Cataract surgery; IFIS; Intraoperative complication; Intraoperative floppy iris syndrome; Patient safety.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Christou CD, Tsinopoulos I, Ziakas N, Tzamalis A (2020) Intraoperative Floppy Iris Syndrome: Updated Perspectives. Clin Ophthalmol 14:463–471. https://doi.org/10.2147/OPTH.S221094 - DOI - PubMed - PMC
    1. Chang DF, Braga-Mele R, Mamalis N et al (2008) ASCRS White Paper: clinical review of intraoperative floppy-iris syndrome. J Cataract Refract Surg 34:2153–2162. https://doi.org/10.1016/j.jcrs.2008.08.031 - DOI - PubMed
    1. Wahl M, Tipotsch-Maca SM, Vecsei-Marlovits PV (2017) Intraoperative floppy iris syndrome and its association with various concurrent medications, bulbus length, patient age and gender. Graefes Arch Clin Exp Ophthalmol 255:113–118. https://doi.org/10.1007/s00417-016-3515-7 - DOI - PubMed
    1. Chang DF, Campbell JR (2005) Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg 31:664–673. https://doi.org/10.1016/j.jcrs.2005.02.027 - DOI - PubMed
    1. Enright JM, Karacal H, Tsai LM (2017) Floppy iris syndrome and cataract surgery. Curr Opin Ophthalmol 28:29–34. https://doi.org/10.1097/ICU.0000000000000322 - DOI - PubMed

LinkOut - more resources