Floppy Iris Syndrome - Frequently Asked Questions
Q: Which doctors treat floppy iris syndrome?
A: An eye surgeon treats floppy iris syndrome.
Q: Does a floppy iris affect vision?
A: If specific complications occur, floppy iris syndrome can impair eyesight. Cystoid macular edema, retinal detachment, and an infection known as endophthalmitis are all possible complications of floppy iris syndrome. These will necessitate care following cataract surgery.
Q: Is floppy iris syndrome permanent?
A: There have been reports and clinical observations that IFIS can occur during cataract surgery even after tamsulosin therapy has been discontinued for years, indicating that the tamsulosin-induced iris damage is likely irreversible.
Q: What medications cause IFIS?
A: Physicians should also remind patients already taking these drugs to report this medication history before having any eye surgery.
The list of drugs associated with intraoperative floppy iris syndrome:
- Alfuzosin
- Chlorpromazine
- Donepezil
- Doxazosin
- Finasteride
- Labetolol Hydrochloride
- Mianserin
- Prazosin
Q: Why is tamsulosin the most preferred drug for benign prostrate hypertrophy?
A: Tamsulosin is an alpha-1 antagonist that is most selective for the urinary tract and has less chance of causing cardiovascular side effects.
Q: Are there any chances of occurrence of the syndrome even after discontinuation of tamsulosin?
A: Yes. The syndrome can occur even years after the discontinuation of tamsulosin.
Q: What causes the iris to sag during cataract surgery?
A: It is predicted that 0.5 to 2% of persons who have cataract surgery will develop floppy iris syndrome. In most cases, this is related to the use of BPH medicine (Benign Prostatic Hyperplasia).
Q: How may floppy iris be avoided?
A: Maintaining mydriasis and preventing the iris from prolapsing during cataract surgery can help prevent and manage IFIS. Mechanical and pharmacologic treatments, as well as the use of intraoperative appropriate phacoemulsification fluidic conditions, can help achieve this.
Q: Can iris prolapse be repaired?
A: The iris can be reseated if it prolapses following a corneal hole. To seal the perforation, use cyanoacrylate adhesive and a bandage contact lens. If the procedure fails or the perforation is extensive, an emergency corneal transplant is required.
Q: What are the signs of a floppy iris?
A: This complication has been found during phaco in individuals being treated with 1-antagonist medications such as tamsulosin (Flomax). The symptoms include iris billowing and floppiness, iris prolapse to the main and side incisions, and progressive pupil constriction during operation.
