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Intraoperative Floppy Iris Syndrome: Updated Perspectives
Almost fifteen years since its initial description, intraoperative floppy iris syndrome (IFIS) during phacoemulsification surgery remains a challenge for cataract surgeons in all its key aspects that include the stratification of the preoperative risk, preoperative prophylaxis treatment, surgery des...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2020
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039091/ https://www.ncbi.nlm.nih.gov/pubmed/32109982 http://dx.doi.org/10.2147/OPTH.S221094 |
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author | Christou, Chrysanthos D Tsinopoulos, Ioannis Ziakas, Nikolaos Tzamalis, Argyrios |
author_facet | Christou, Chrysanthos D Tsinopoulos, Ioannis Ziakas, Nikolaos Tzamalis, Argyrios |
author_sort | Christou, Chrysanthos D |
collection | PubMed |
description | Almost fifteen years since its initial description, intraoperative floppy iris syndrome (IFIS) during phacoemulsification surgery remains a challenge for cataract surgeons in all its key aspects that include the stratification of the preoperative risk, preoperative prophylaxis treatment, surgery design and intraoperative management. Since its original association with tamsulosin intake, IFIS has been positively correlated with a plethora of risk factors which include: gender, age, hypertension, other a1-adrenergic receptor antagonists, finasteride, angiotensin II receptor inhibitors, benzodiazepines, antipsychotics, hypertension drugs and decreased dilated pupil diameter. The assessment and stratification of the preoperative risk is pivotal in screening patients prone to develop IFIS. For these patients, it is essential that preoperative prophylaxis, employment of necessary measures and surgical technique modifications are considered. A multidisciplinary approach of IFIS is a mandate, thus ophthalmologists, urologists and sometimes other specialties should cooperate to “educate” each other about the risks of their respective fields. They both must be aware of the joint statement on IFIS by the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery which suggests either the initiation of tamsulosin after phacoemulsification or the use of a non-selective a1-ARA for benign prostatic hyperplasia treatment. In conclusion, awareness of the risk factors associated with IFIS and their detailed preoperative documentation is crucial in addressing IFIS. The lack of such an awareness can turn a routine, uneventful surgery into one with significant visual morbidity. |
format | Online Article Text |
id | pubmed-7039091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-70390912020-02-27 Intraoperative Floppy Iris Syndrome: Updated Perspectives Christou, Chrysanthos D Tsinopoulos, Ioannis Ziakas, Nikolaos Tzamalis, Argyrios Clin Ophthalmol Review Almost fifteen years since its initial description, intraoperative floppy iris syndrome (IFIS) during phacoemulsification surgery remains a challenge for cataract surgeons in all its key aspects that include the stratification of the preoperative risk, preoperative prophylaxis treatment, surgery design and intraoperative management. Since its original association with tamsulosin intake, IFIS has been positively correlated with a plethora of risk factors which include: gender, age, hypertension, other a1-adrenergic receptor antagonists, finasteride, angiotensin II receptor inhibitors, benzodiazepines, antipsychotics, hypertension drugs and decreased dilated pupil diameter. The assessment and stratification of the preoperative risk is pivotal in screening patients prone to develop IFIS. For these patients, it is essential that preoperative prophylaxis, employment of necessary measures and surgical technique modifications are considered. A multidisciplinary approach of IFIS is a mandate, thus ophthalmologists, urologists and sometimes other specialties should cooperate to “educate” each other about the risks of their respective fields. They both must be aware of the joint statement on IFIS by the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgery which suggests either the initiation of tamsulosin after phacoemulsification or the use of a non-selective a1-ARA for benign prostatic hyperplasia treatment. In conclusion, awareness of the risk factors associated with IFIS and their detailed preoperative documentation is crucial in addressing IFIS. The lack of such an awareness can turn a routine, uneventful surgery into one with significant visual morbidity. Dove 2020-02-20 /pmc/articles/PMC7039091/ /pubmed/32109982 http://dx.doi.org/10.2147/OPTH.S221094 Text en © 2020 Christou et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Review Christou, Chrysanthos D Tsinopoulos, Ioannis Ziakas, Nikolaos Tzamalis, Argyrios Intraoperative Floppy Iris Syndrome: Updated Perspectives |
title | Intraoperative Floppy Iris Syndrome: Updated Perspectives |
title_full | Intraoperative Floppy Iris Syndrome: Updated Perspectives |
title_fullStr | Intraoperative Floppy Iris Syndrome: Updated Perspectives |
title_full_unstemmed | Intraoperative Floppy Iris Syndrome: Updated Perspectives |
title_short | Intraoperative Floppy Iris Syndrome: Updated Perspectives |
title_sort | intraoperative floppy iris syndrome: updated perspectives |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7039091/ https://www.ncbi.nlm.nih.gov/pubmed/32109982 http://dx.doi.org/10.2147/OPTH.S221094 |
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