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A narrative review of intraoperative floppy iris syndrome: an update 2020

Intraoperative floppy iris syndrome (IFIS) is characterized by intraoperative floppiness or billowing of the iris, progressive miosis, and iris prolapse through the surgical wounds. It was originally reported about fifteen years ago, which was later identified to be closely associated with tamsulosi...

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Autores principales: Yang, Xue, Liu, Zhaochuan, Fan, Zhigang, Grzybowski, Andrzej, Wang, Ningli
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729334/
https://www.ncbi.nlm.nih.gov/pubmed/33313291
http://dx.doi.org/10.21037/atm-20-3214
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author Yang, Xue
Liu, Zhaochuan
Fan, Zhigang
Grzybowski, Andrzej
Wang, Ningli
author_facet Yang, Xue
Liu, Zhaochuan
Fan, Zhigang
Grzybowski, Andrzej
Wang, Ningli
author_sort Yang, Xue
collection PubMed
description Intraoperative floppy iris syndrome (IFIS) is characterized by intraoperative floppiness or billowing of the iris, progressive miosis, and iris prolapse through the surgical wounds. It was originally reported about fifteen years ago, which was later identified to be closely associated with tamsulosin, the most commonly used α1 adrenoceptor antagonist for benign prostatic hyperplasia (BPH). A variety of risk factors, including age, gender, hypertension, axial length of the eye, 5α-reductase inhibitors, other α adrenoceptor antagonist and neuromodulators, have been connected with IFIS. If IFIS occurs during phacoemulsification surgery, complications such as corneal endothelial loss, iris trauma, posterior capsule rupture (PCR), high intraocular pressure and vitreous loss are significantly increased. Therefore, preoperative evaluation of high-risk patients and appropriate intraoperative intervention is crucial to avoid severe complications. This review summarizes the pathogenesis and clinical features of classic IFIS, and provides some clinical pearls to ophthalmologists that may help identify, prevent or reduce IFIS associated complications. Additionally, from the perspective of clinical occurrence of IFIS, there are some recommendations for urologists as well. In conclusion, both ophthalmologists and urologists should be aware of this special clinical situation and communicate with each other about their own fields. A multidisciplinary interaction is of importance to simplify potentially complicated clinical issues.
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spelling pubmed-77293342020-12-11 A narrative review of intraoperative floppy iris syndrome: an update 2020 Yang, Xue Liu, Zhaochuan Fan, Zhigang Grzybowski, Andrzej Wang, Ningli Ann Transl Med Review Article on Recent Developments in Cataract Surgery Intraoperative floppy iris syndrome (IFIS) is characterized by intraoperative floppiness or billowing of the iris, progressive miosis, and iris prolapse through the surgical wounds. It was originally reported about fifteen years ago, which was later identified to be closely associated with tamsulosin, the most commonly used α1 adrenoceptor antagonist for benign prostatic hyperplasia (BPH). A variety of risk factors, including age, gender, hypertension, axial length of the eye, 5α-reductase inhibitors, other α adrenoceptor antagonist and neuromodulators, have been connected with IFIS. If IFIS occurs during phacoemulsification surgery, complications such as corneal endothelial loss, iris trauma, posterior capsule rupture (PCR), high intraocular pressure and vitreous loss are significantly increased. Therefore, preoperative evaluation of high-risk patients and appropriate intraoperative intervention is crucial to avoid severe complications. This review summarizes the pathogenesis and clinical features of classic IFIS, and provides some clinical pearls to ophthalmologists that may help identify, prevent or reduce IFIS associated complications. Additionally, from the perspective of clinical occurrence of IFIS, there are some recommendations for urologists as well. In conclusion, both ophthalmologists and urologists should be aware of this special clinical situation and communicate with each other about their own fields. A multidisciplinary interaction is of importance to simplify potentially complicated clinical issues. AME Publishing Company 2020-11 /pmc/articles/PMC7729334/ /pubmed/33313291 http://dx.doi.org/10.21037/atm-20-3214 Text en 2020 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Recent Developments in Cataract Surgery
Yang, Xue
Liu, Zhaochuan
Fan, Zhigang
Grzybowski, Andrzej
Wang, Ningli
A narrative review of intraoperative floppy iris syndrome: an update 2020
title A narrative review of intraoperative floppy iris syndrome: an update 2020
title_full A narrative review of intraoperative floppy iris syndrome: an update 2020
title_fullStr A narrative review of intraoperative floppy iris syndrome: an update 2020
title_full_unstemmed A narrative review of intraoperative floppy iris syndrome: an update 2020
title_short A narrative review of intraoperative floppy iris syndrome: an update 2020
title_sort narrative review of intraoperative floppy iris syndrome: an update 2020
topic Review Article on Recent Developments in Cataract Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729334/
https://www.ncbi.nlm.nih.gov/pubmed/33313291
http://dx.doi.org/10.21037/atm-20-3214
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