Alpha antagonists and intraoperative floppy iris syndrome: A spectrum

Sharif A Issa, Omar H Hadid, Oliver Baylis, Margaret DayanDepartment of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UKBackground: To determine occurrence of features of intraoperative floppy iris syndrome (IFIS) during cataract surgery in patients taking systemic alpha-antagonists...

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Autores principales:	Sharif A Issa, Omar H Hadid, Oliver Baylis, Margaret Dayan
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/04b78b11ee524a6ca757af9eab098624
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spelling	oai:doaj.org-article:04b78b11ee524a6ca757af9eab0986242021-12-02T10:06:33ZAlpha antagonists and intraoperative floppy iris syndrome: A spectrum1177-54671177-5483https://doaj.org/article/04b78b11ee524a6ca757af9eab0986242008-07-01T00:00:00Zhttp://www.dovepress.com/alpha-antagonists-and-intraoperative-floppy-iris-syndrome-a-spectrum-a1720https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Sharif A Issa, Omar H Hadid, Oliver Baylis, Margaret DayanDepartment of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UKBackground: To determine occurrence of features of intraoperative floppy iris syndrome (IFIS) during cataract surgery in patients taking systemic alpha-antagonists (AA).Methods: We prospectively studied patients on AA and who underwent phacoemulsification. The following were recorded: pupil diameter preoperatively, iris flaccidity, iris prolapse and peroperative miosis.Results: We studied 40 eyes of 31 subjects. Mean age was 78 years. Overall, 14 eyes (13 patients) showed signs of IFIS: 9/13 (69%) eyes of patients on tamsulosin, 1/18 (6%) eyes in the doxazosin group, 2/2 prazosin patients, 1/4 eyes in the indoramin group, and 1/2 eyes in two patients on a combination of doxazosin and tamsulosin. Most cases (92%) had only one or two signs of IFIS. Bilateral cataract surgery was undertaken in 9 patients but only one patient (on tamsulosin) had features of IFIS in both eyes, while 4 patients (2 on tamsulosin and 2 on other AA) showed signs of IFIS in one eye only, and 4 patients did not show IFIS in either eye.Conclusion: Most AA were associated with IFIS, but it tends to present as a spectrum of signs rather than full triad originally described. Tamsulosin was most likely to be associated with IFIS; however, its intake does not necessarily mean that IFIS will occur. For patients on AA, the behavior of the iris intraoperatively in one eye is a poor predictor of the other eye. Surgeons should anticipate the occurrence of IFIS in any patient on AA.Keywords: alpha blocker, alpha antagonist, cataract surgery, intraoperative floppy iris syndrome, tamsulosin. Sharif A IssaOmar H HadidOliver BaylisMargaret DayanDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 4, Pp 735-741 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sharif A Issa Omar H Hadid Oliver Baylis Margaret Dayan Alpha antagonists and intraoperative floppy iris syndrome: A spectrum
description	Sharif A Issa, Omar H Hadid, Oliver Baylis, Margaret DayanDepartment of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UKBackground: To determine occurrence of features of intraoperative floppy iris syndrome (IFIS) during cataract surgery in patients taking systemic alpha-antagonists (AA).Methods: We prospectively studied patients on AA and who underwent phacoemulsification. The following were recorded: pupil diameter preoperatively, iris flaccidity, iris prolapse and peroperative miosis.Results: We studied 40 eyes of 31 subjects. Mean age was 78 years. Overall, 14 eyes (13 patients) showed signs of IFIS: 9/13 (69%) eyes of patients on tamsulosin, 1/18 (6%) eyes in the doxazosin group, 2/2 prazosin patients, 1/4 eyes in the indoramin group, and 1/2 eyes in two patients on a combination of doxazosin and tamsulosin. Most cases (92%) had only one or two signs of IFIS. Bilateral cataract surgery was undertaken in 9 patients but only one patient (on tamsulosin) had features of IFIS in both eyes, while 4 patients (2 on tamsulosin and 2 on other AA) showed signs of IFIS in one eye only, and 4 patients did not show IFIS in either eye.Conclusion: Most AA were associated with IFIS, but it tends to present as a spectrum of signs rather than full triad originally described. Tamsulosin was most likely to be associated with IFIS; however, its intake does not necessarily mean that IFIS will occur. For patients on AA, the behavior of the iris intraoperatively in one eye is a poor predictor of the other eye. Surgeons should anticipate the occurrence of IFIS in any patient on AA.Keywords: alpha blocker, alpha antagonist, cataract surgery, intraoperative floppy iris syndrome, tamsulosin.
format	article
author	Sharif A Issa Omar H Hadid Oliver Baylis Margaret Dayan
author_facet	Sharif A Issa Omar H Hadid Oliver Baylis Margaret Dayan
author_sort	Sharif A Issa
title	Alpha antagonists and intraoperative floppy iris syndrome: A spectrum
title_short	Alpha antagonists and intraoperative floppy iris syndrome: A spectrum
title_full	Alpha antagonists and intraoperative floppy iris syndrome: A spectrum
title_fullStr	Alpha antagonists and intraoperative floppy iris syndrome: A spectrum
title_full_unstemmed	Alpha antagonists and intraoperative floppy iris syndrome: A spectrum
title_sort	alpha antagonists and intraoperative floppy iris syndrome: a spectrum
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/04b78b11ee524a6ca757af9eab098624
work_keys_str_mv	AT sharifaissa alphaantagonistsandintraoperativefloppyirissyndromeaspectrum AT omarhhadid alphaantagonistsandintraoperativefloppyirissyndromeaspectrum AT oliverbaylis alphaantagonistsandintraoperativefloppyirissyndromeaspectrum AT margaretdayan alphaantagonistsandintraoperativefloppyirissyndromeaspectrum
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Alpha antagonists and intraoperative floppy iris syndrome: A spectrum

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