Which medication can cause intraoperative floppy iris syndrome in cataract surgery patients?

The uroselective alpha-blocker tamsulosin is the most commonly used drug among all. Studies showed that the majority of the patients who develop intraoperative floppy iris syndrome (IFIS) were on tamsulosin.

How do you prevent floppy iris?

To prevent IFIS and its signs, Samuel Masket described pre-medicating at-risk patients with topical atropine sulfate 1% three times a day for two days before surgery, standard mydriatics and intraoperative intracameral epinephrine, attributing success in 19/20 eyes to synergy between the pupillary block provided by …

Does tamsulosin cause floppy iris?

Intraoperative floppy iris syndrome has most commonly been associated with tamsulosin, a selective alpha1 adrenergic antagonist used for relief of lower urinary tract symptoms associated with benign prostatic hypertrophy. The syndrome is nine times more prevalent in males.

What causes intraoperative floppy iris syndrome?

This syndrome is characterized by a flaccid iris which billows in response to ordinary intraocular fluid currents, a propensity for this floppy iris to prolapse towards the area of cataract extraction during surgery, and progressive intraoperative pupil constriction despite standard procedures to prevent this.

Does Floppy iris affect vision?

The iris can also slip out of its normal position during surgery, making it even harder for the ophthalmologist to remove the old lens and insert a new one. This condition, dubbed floppy iris syndrome, increases the chance of complications, including vision loss.

What is intraoperative floppy iris syndrome?

Intraoperative floppy iris syndrome (IFIS) is a recently described phenomenon affecting cataract surgery. It consists of poor preoperative pupil dilation together with progressive intraoperative pupil constriction, billowing of a flaccid iris stroma, and iris prolapse to the surgical incisions.

Does Tamsulosin affect eyesight?

In patients who are taking or have taken Flomax or other alpha-blockers, the iris may not stay dilated during surgery. If the iris problems are not anticipated or recognized, there is an increased risk of surgical complications. Flomax does not affect vision and does not pose any other problems with eye health.

Does alfuzosin cause floppy iris syndrome?

Patients taking systemic alfuzosin for benign prostatic hyperplasia (BPH) were less likely to experience moderate or severe intraoperative floppy iris syndrome (IFIS) during cataract surgery than patients taking tamsulosin (Flomax, Astellas Pharma), according to a head-to-head comparison published online December 5 in …

Does doxazosin cause floppy iris syndrome?

Thirty-seven percent of the doxazosin patients (45% of eyes) had floppy irides. This is a greater proportion than that noted by Chang and Campbell or any other study to date. Eighty-three percent of the tamsulosin patients (88% of eyes) had floppy irides, supporting the finding in the Chang and Campbell study.

Which is the best drug for floppy iris syndrome?

There are four alpha-AR antagonists currently available to treat BPH. The uroselective alpha-blocker tamsulosin is the most commonly used drug among all. Studies showed that the majority of the patients who develop intraoperative floppy iris syndrome (IFIS) were on tamsulosin.

Why does Flomax cause Intraoperative floppy iris syndrome?

Managing Intraoperative Floppy Iris Syndrome. The reason why Flomax can cause IFIS is the same as the reason for its mechanism of action for treating BPH: Flomax relaxes the smooth muscle of the bladder neck—and, inadvertently, the iris dilator as well—by specifically targeting the alpha 1A receptors.

Can a cataract surgery cause floppy iris syndrome?

Tamsulosin is the most common cause of formation of IFIS. However, not all patients given tamsulosin develop IFIS and cases have been reported without any tamsulosin treatment. Conclusion Tamsulosin is a recognized cause to impede mydriasis and lead to IFIS during cataract surgery.

How is tamsulosin linked to floppy iris syndrome?

The use of tamsulosin is considered a significant cause behind floppy iris syndrome. Studies show up to 87% of patients with the syndrome took tamsulosin in the past. This is a drug commonly used to treat enlarged prostate in men . Other types of alpha-blocker drugs may also contribute to a higher risk of floppy iris syndrome.