Intraoperative Floppy Iris Syndrome: Updated Perspectives

Chrysanthos D Christou,* Ioannis Tsinopoulos, Nikolaos Ziakas, Argyrios Tzamalis* 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece*These authors contributed equally to this workCorrespondence: Argyrios Tzamalis 2nd Department...

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Autores principales:	Christou CD, Tsinopoulos I, Ziakas N, Tzamalis A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	intraoperative floppy iris syndrome ifis risk factors preoperative prophylaxis intraoperative management Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/2b42182191e14b1ebb4e8f81b28c5460
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spelling	oai:doaj.org-article:2b42182191e14b1ebb4e8f81b28c54602021-12-02T04:07:37ZIntraoperative Floppy Iris Syndrome: Updated Perspectives1177-5483https://doaj.org/article/2b42182191e14b1ebb4e8f81b28c54602020-02-01T00:00:00Zhttps://www.dovepress.com/intraoperative-floppy-iris-syndrome-updated-perspectives-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Chrysanthos D Christou,* Ioannis Tsinopoulos, Nikolaos Ziakas, Argyrios Tzamalis* 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece*These authors contributed equally to this workCorrespondence: Argyrios Tzamalis 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GreeceTel +30 69 4206 0467Fax +30 23 1332 3974Email argyriostzamalis@yahoo.comAbstract: 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.Keywords: intraoperative floppy iris syndrome, IFIS, risk factors, preoperative prophylaxis, intraoperative managementChristou CDTsinopoulos IZiakas NTzamalis ADove Medical Pressarticleintraoperative floppy iris syndromeifisrisk factorspreoperative prophylaxisintraoperative managementOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 463-471 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	intraoperative floppy iris syndrome ifis risk factors preoperative prophylaxis intraoperative management Ophthalmology RE1-994
spellingShingle	intraoperative floppy iris syndrome ifis risk factors preoperative prophylaxis intraoperative management Ophthalmology RE1-994 Christou CD Tsinopoulos I Ziakas N Tzamalis A Intraoperative Floppy Iris Syndrome: Updated Perspectives
description	Chrysanthos D Christou,* Ioannis Tsinopoulos, Nikolaos Ziakas, Argyrios Tzamalis* 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece*These authors contributed equally to this workCorrespondence: Argyrios Tzamalis 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GreeceTel +30 69 4206 0467Fax +30 23 1332 3974Email argyriostzamalis@yahoo.comAbstract: 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.Keywords: intraoperative floppy iris syndrome, IFIS, risk factors, preoperative prophylaxis, intraoperative management
format	article
author	Christou CD Tsinopoulos I Ziakas N Tzamalis A
author_facet	Christou CD Tsinopoulos I Ziakas N Tzamalis A
author_sort	Christou CD
title	Intraoperative Floppy Iris Syndrome: Updated Perspectives
title_short	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_sort	intraoperative floppy iris syndrome: updated perspectives
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/2b42182191e14b1ebb4e8f81b28c5460
work_keys_str_mv	AT christoucd intraoperativefloppyirissyndromeupdatedperspectives AT tsinopoulosi intraoperativefloppyirissyndromeupdatedperspectives AT ziakasn intraoperativefloppyirissyndromeupdatedperspectives AT tzamalisa intraoperativefloppyirissyndromeupdatedperspectives
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Intraoperative Floppy Iris Syndrome: Updated Perspectives

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