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Floppy Iris Syndrome

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1. Best Prophylactic Strategy in Groups at Risk of Intraoperative Floppy Iris Syndrome Development: Comparison Between Atropine Instillation and Adrenaline Intracameral Injection (PubMed)

Best Prophylactic Strategy in Groups at Risk of Intraoperative Floppy Iris Syndrome Development: Comparison Between Atropine Instillation and Adrenaline Intracameral Injection Intraoperative Floppy Iris Syndrome (IFIS) is an important cause of surgical complications and iris defects in patients undergoing phacoemulsification that were treated with selective subtype α1A receptor antagonists for a long period of time. To date, no definitive preventive strategy has emerged, yet. The need (...) chamber. All phacoemulsifications were videotaped in order to assess the occurrence of IFIS and the severity of the syndrome.The treatment group showed a statistically significant reduction (p = 0.0115) of floppy iris syndrome incidence, from 86.05% (37/43) of the atropine group to 60.53% (23/38). The analysis showed a reduction of IFIS mild form only, whereas the incidence of severe forms remained unchanged.We believe that IFIS may arise through two different mechanisms: pharmacological antagonism

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2018 The open ophthalmology journal

2. Effect of phenylephrine 1.0%-ketorolac 0.3% injection on tamsulosin-associated intraoperative floppy-iris syndrome. (PubMed)

Effect of phenylephrine 1.0%-ketorolac 0.3% injection on tamsulosin-associated intraoperative floppy-iris syndrome. To determine the effect of phenylephrine 1.0%-ketorolac 0.3% injection (Omidria) on different components of intraoperative floppy-iris syndrome (IFIS).Silverstein Eye Centers, Kansas City, Missouri, USA.Prospective case series.Men treated with tamsulosin having standard cataract extraction surgery were placed in a treatment group that received phenylephrine 1.0%-ketorolac 0.3 (...) % injection in the irrigation solution and a control group) that received basic saline solution. Every procedure was video recorded using an endocyclophotocoagulation (ECP) probe and microscopic view. Pupil dilation, iris billowing, and iris prolapse were measured using a micrometer, ECP recording grading scale, and microscopic recordings, respectively.Each group (treatment and control) comprised 25 eyes of 25 patients. Although both groups had a decrease in pupil diameter before and after cataract

2018 Journal of cataract and refractive surgery

3. The role of sex in intraoperative floppy-iris syndrome. (PubMed)

The role of sex in intraoperative floppy-iris syndrome. To compare the incidence of intraoperative floppy-iris syndrome (IFIS) between male and female patients undergoing phacoemulsification cataract surgery, evaluate risk factors for its appearance in each sex, and assess any differences in the final visual outcomes.2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Greece.Comparative retrospective case-control study.Cataract patients with recorded IFIS of any severity

2018 Journal of cataract and refractive surgery

4. Ten years of intraoperative floppy iris syndrome in the era of α-blockers (PubMed)

Ten years of intraoperative floppy iris syndrome in the era of α-blockers The use of alpha-1 receptor antagonists in the treatment of benign prostatic hyperplasia (BPH) has created a problem in ophthalmic surgery, the so-called intraoperative floppy iris syndrome (IFIS). This consists of a billowing iris, insufficient pupillary dilation with progressive intraoperative miosis, and protrusion of iris tissue through the tunnel and side port incision that are made for access to the anterior (...) ', 'intraoperative floppy iris syndrome', 'adrenergic alpha-antagonist' and 'cataract surgery'. In addition, reference lists from identified publications were reviewed to identify reports and studies of interest from 2001 to 2017.The A total of 95% of experienced ophthalmologic surgeons reported that systematic treatment with tamsulosin represents a challenging surgical condition increasing the risk of complications. Alpha-blockers are commonly prescribed, with 1,079,505 packages of tamsulosin prescribed each

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2017 Central European journal of urology

5. Phytotherapy and intraoperative floppy iris syndrome: the implications (PubMed)

Phytotherapy and intraoperative floppy iris syndrome: the implications 28257133 2018 05 11 2019 01 15 1476-5454 31 6 2017 06 Eye (London, England) Eye (Lond) Phytotherapy and intraoperative floppy iris syndrome: the implications. 823-826 10.1038/eye.2017.16 Tsatsos M M University Hospital Southampton NHS Foundation Trust, Eye Clinic,Southampton, UK. MacGregor C C University Hospital Southampton NHS Foundation Trust, Eye Clinic,Southampton, UK. Athanasiadis I I 0000-0002-6236-7540 Eye Department (...) Intraoperative Complications drug therapy Iris Diseases drug therapy Phytotherapy methods 2017 3 4 6 0 2018 5 12 6 0 2017 3 4 6 0 ppublish 28257133 eye201716 10.1038/eye.2017.16 PMC5518834 J Cataract Refract Surg. 2007 Jul;33(7):1227-34 17586379 BJU Int. 2000 May;85(7):836-41 10792162 Acta Ophthalmol Scand. 2005 Oct;83(5):624-6 16188009 Ophthalmology. 2011 Apr;118(4):730-5 21168223 Ophthalmology. 2009 Apr;116(4):658-63 19243826 Curr Urol. 2012 May;6(1):1-7 24917702 Invest Ophthalmol Vis Sci. 2006 Sep;47(9

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2017 Eye

6. Silodosin-associated intraoperative floppy iris syndrome (PubMed)

Silodosin-associated intraoperative floppy iris syndrome 28643727 2017 12 15 2018 11 13 1998-3689 65 6 2017 Jun Indian journal of ophthalmology Indian J Ophthalmol Silodosin-associated intraoperative floppy iris syndrome. 538-539 10.4103/ijo.IJO_704_16 Chatterjee Samrat S Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India. Agrawal Deepshikha D Cornea and Anterior Segment Services, MGM Eye Institute, Raipur, Chhattisgarh, India. eng Case Reports Letter India (...) Indian J Ophthalmol 0405376 0301-4738 0 Adrenergic alpha-1 Receptor Antagonists 0 Indoles CUZ39LUY82 silodosin IM Adrenergic alpha-1 Receptor Antagonists adverse effects Aged Humans Indoles adverse effects Intraoperative Complications chemically induced Iris Diseases chemically induced Male Phacoemulsification Prolapse Prostatic Hyperplasia drug therapy 2017 6 24 6 0 2017 6 24 6 0 2017 12 16 6 0 ppublish 28643727 IndianJOphthalmol_2017_65_6_538_208895 10.4103/ijo.IJO_704_16 PMC5508473 Acta Ophthalmol

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2017 Indian journal of ophthalmology

7. Floppy iris syndrome and cataract surgery. (PubMed)

Floppy iris syndrome and cataract surgery. Intraoperative floppy iris syndrome (IFIS) occurs in 2% of cataract surgeries and is associated with an increased risk of surgical complications. These complications can be avoided when high-risk patients are identified by preoperative screening and appropriate measures are used intraoperatively. The purpose of this article is to review emerging risk factors for IFIS and to summarize management strategies used in IFIS.Although α1-antagonists in general

2016 Current Opinion in Ophthalmology

8. Floppy Iris Syndrome

Floppy Iris Syndrome Floppy Iris Syndrome Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Floppy Iris Syndrome Floppy Iris Syndrome (...) Aka: Floppy Iris Syndrome II. Pathophysiology: Intraoperative Floppy Iris Syndrome Sudden prolapse and in surgery Related to medications III. Causes Specific Alpha-1 adrenergic antagonists (highest risk) ( ) Non-specific s ( ) ( ) ( ) ( ) s with activity ( ) ( ) Other agents with alpha-adrenergic antagonist activity Clorpromazine IV. Complications ( ) increases the complication risk most significantly (as much as 2.3 times) Complications include Lost lens fragment Severe iris defects V. Prevention

2018 FP Notebook

9. Assessment of Urologists' Knowledge of Intraoperative Floppy Iris Syndrome. (PubMed)

Assessment of Urologists' Knowledge of Intraoperative Floppy Iris Syndrome. To assess urologists' awareness of intraoperative floppy iris syndrome.A questionnaire composed of 21 questions was emailed to all of the Urology residency programs in the U.S. and all members of the Western section of the American Urological Association. Responses were collected and analyzed using statistical software.A total of 175 responses were collected from residents, fellows, and attending physicians from a wide (...) range of geographic locations, subspecialties, and practice settings. Thirty percent of the urologists would routinely discuss intraoperative floppy iris syndrome with patients prior to start of benign prostate hyperplasia treatment. Twenty-one percent of the respondents never asked patients about ophthalmologic conditions prior to benign prostate hyperplasia treatment. If patients had concurrent visual complaints, only 37% of the respondents would routinely encourage patients to speak

2016 Urology

10. Modified Surgical Techniques for Managing Intraoperative Floppy Iris Syndrome (PubMed)

Modified Surgical Techniques for Managing Intraoperative Floppy Iris Syndrome Purpose. To report a modified surgical strategy in the management of intraoperative floppy iris syndrome-associated iris prolapse. Methods. Prolapsed iris is left as is and a new corneal incision near the original wound but at a different site is created. Depending on the location of the original incision and the surgeon's preference, this additional incision can be used as a new port for phacoemulsification tip (...) or can be the new site for the iris to securely prolapse, allowing for the surgery to proceed safely. Results. We present 2 cases of iris prolapse and inadequate pupil dilation in patients with IFIS. Along with our modified technique, additional iris retractors were placed to increase the workspace for the phacoemulsification tip. The cataract surgery was performed successfully without further complications in both cases. Conclusion. This surgical technique could be an adjunct to allow the surgeons

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2016 Case reports in ophthalmological medicine

11. Risk factors for intraoperative floppy iris syndrome: a prospective study (PubMed)

Risk factors for intraoperative floppy iris syndrome: a prospective study PurposeTo evaluate risk factors for intraoperative floppy iris syndrome (IFIS) in patients undergoing phacoemulsification.MethodsParticipants in the study were 1274 consecutive patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors: ophthalmological conditions, axial length of the eye, sociodemographic features, clinical data

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2016 Eye

12. Sub-Tenon injection of 2% lidocaine prevents intra-operative floppy iris syndrome (IFIS) in male patients taking oral α-adrenergic antagonists.

Sub-Tenon injection of 2% lidocaine prevents intra-operative floppy iris syndrome (IFIS) in male patients taking oral α-adrenergic antagonists.   To compare 2% sub-Tenon and 1% intra-cameral lidocaine for cataract surgery in relation to the incidence and severity of IFIS. Prospective randomized clinical study.  From 81 eligible, we included 71 men aged from 59 to 90 years (mean 76.5 ± 6.8) undergoing routine cataract surgery and taking oral α-adrenergic antagonists, for urological reasons (...) , for more than 1 year. Following randomization 34 men, aged from 62 to 90 years (mean 77.4 ± 8.1) received sub-Tenon injection of 2.5 ml of 2% lidocaine and the remaining 37 men aged from 59 to 89 years (mean 75.2 ± 7.2) received 1% preservative free intra-cameral lidocaine. Outcome measures were the incidence of IFIS, severity of intra-operative pupillary constriction and iris prolapse.  Intra-operative floppy iris syndrome (IFIS) was noted in 3 of 34 patients (8.8%) receiving sub-Tenon lidocaine

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2014 Acta ophthalmologica

13. A Randomized, Placebo-controlled Study in Subjects at High Risk of Intraoperative Floppy Iris Syndrome Undergoing Intraocular Lens Replacement Surgery

A Randomized, Placebo-controlled Study in Subjects at High Risk of Intraoperative Floppy Iris Syndrome Undergoing Intraocular Lens Replacement Surgery Intraoperative Floppy Iris Syndrome Undergoing Intraocular Lens Replacement Surgery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number (...) of saved studies (100). Please remove one or more studies before adding more. Intraoperative Floppy Iris Syndrome Undergoing Intraocular Lens Replacement Surgery The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02093689 Recruitment Status : Terminated (Pupil measurement methodology determined

2014 Clinical Trials

14. Sub-Tenon injection of 2% lidocaine prevents intra-operative floppy iris syndrome (IFIS) in male patients taking oral α-adrenergic antagonists. (PubMed)

Sub-Tenon injection of 2% lidocaine prevents intra-operative floppy iris syndrome (IFIS) in male patients taking oral α-adrenergic antagonists.   To compare 2% sub-Tenon and 1% intra-cameral lidocaine for cataract surgery in relation to the incidence and severity of IFIS. Prospective randomized clinical study.  From 81 eligible, we included 71 men aged from 59 to 90 years (mean 76.5 ± 6.8) undergoing routine cataract surgery and taking oral α-adrenergic antagonists, for urological reasons (...) , for more than 1 year. Following randomization 34 men, aged from 62 to 90 years (mean 77.4 ± 8.1) received sub-Tenon injection of 2.5 ml of 2% lidocaine and the remaining 37 men aged from 59 to 89 years (mean 75.2 ± 7.2) received 1% preservative free intra-cameral lidocaine. Outcome measures were the incidence of IFIS, severity of intra-operative pupillary constriction and iris prolapse.  Intra-operative floppy iris syndrome (IFIS) was noted in 3 of 34 patients (8.8%) receiving sub-Tenon lidocaine

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2014 Acta ophthalmologica

15. Effects of tamsulosin and silodosin on isolated albino and pigmented rabbit iris dilators: possible mechanism of intraoperative floppy-iris syndrome. (PubMed)

Effects of tamsulosin and silodosin on isolated albino and pigmented rabbit iris dilators: possible mechanism of intraoperative floppy-iris syndrome. To determine the mechanism of intraoperative floppy-iris syndrome (IFIS) by examining the binding affinity of tamsulosin and silodosin to α-receptors and melanin pigment using control and α(2)-blocker chronically administered in rabbit models.Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan.Experimental (...) study.The study was performed in isolated albino and pigmented rabbit iris dilators using pharmacologic and morphologic examinations.For pharmacologic examinations, the mean pK(B) values (pK(B) = -log K(B), where -log K(B) is the equilibrium dissociation constant of the antagonist-receptor complex) of tamsulosin in albino and pigmented rabbits were 9.10 and 8.08 and those of silodosin, 10.3 and 8.11, respectively. The pK(B) values of tamsulosin and silodosin in albino rabbits were significantly higher

2012 Journal of cataract and refractive surgery

16. Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery

Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Risperidone and paliperidone: risk of intraoperative floppy iris syndrome in patients undergoing cataract surgery Cases of intraoperative floppy iris syndrome (IFIS) during cataract surgery have been (...) reported in patients taking the atypical antipsychotics risperidone or paliperidone. Published 11 December 2014 From: Therapeutic area: , , , Article date: November 2013 Intraoperative floppy iris syndrome (IFIS) is a complication observed during cataract surgery that was first described in 2005 in association with the α1-adrenergic antagonist tamsulosin. α1-adrenergic receptors are present in the iris dilator muscle of the eye, where inhibition of the receptors relaxes this muscle causing a floppy

2013 MHRA Drug Safety Update

17. Prospective Masked Comparison of Intraoperative Floppy Iris Syndrome Severity with Tamsulosin versus Alfuzosin. (PubMed)

Prospective Masked Comparison of Intraoperative Floppy Iris Syndrome Severity with Tamsulosin versus Alfuzosin. To determine whether severe intraoperative floppy iris syndrome (IFIS) is more or equally likely with tamsulosin or alfuzosin.Prospective, masked, multicenter, cross-sectional study.Consecutive patients taking systemic tamsulosin or alfuzosin and scheduled for routine cataract surgery (case group) and patients with no history of systemic α1-antagonists scheduled for routine cataract (...) surgery (control group).Phacoemulsification with intraocular lens implantation was performed and recorded on video. Intracameral phenylephrine or epinephrine, either by direct injection or placement in the irrigation bottle, was not permitted. Every surgical video subsequently was reviewed remotely by 2 masked investigators who diagnosed the presence or absence of IFIS and graded the severity of IFIS as follows: none, mild (billowing only), moderate (billowing and either iris prolapse or ≥2 mm

2013 Ophthalmology

18. Methods to Manage Intra-operative Floppy-iris Syndrome and Poor Pupil Dilation in Cataract Surgery

Methods to Manage Intra-operative Floppy-iris Syndrome and Poor Pupil Dilation in Cataract Surgery Methods to Manage Intra-operative Floppy-iris Syndrome and Poor Pupil Dilation in Cataract Surgery - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove (...) one or more studies before adding more. Methods to Manage Intra-operative Floppy-iris Syndrome and Poor Pupil Dilation in Cataract Surgery (IFIS) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01778959 Recruitment Status : Unknown Verified January 2013 by Prim. Prof. Dr. Oliver Findl, MBA, Vienna

2013 Clinical Trials

19. Intraoperative floppy iris syndrome associated with quetiapine (PubMed)

Intraoperative floppy iris syndrome associated with quetiapine 23492861 2013 11 18 2018 11 13 1476-5454 27 5 2013 May Eye (London, England) Eye (Lond) Intraoperative floppy iris syndrome associated with quetiapine. 673 10.1038/eye.2013.40 Bilgin B B Ilhan D D Çetinkaya A A Ünal M M eng Case Reports Letter 2013 03 15 England Eye (Lond) 8703986 0950-222X 0 Antipsychotic Agents 0 Dibenzothiazepines 2S3PL1B6UJ Quetiapine Fumarate IM Antipsychotic Agents adverse effects Dibenzothiazepines adverse (...) effects Female Humans Intraoperative Complications Iris Diseases chemically induced Middle Aged Phacoemulsification Quetiapine Fumarate 2013 3 16 6 0 2013 3 16 6 0 2013 11 19 6 0 ppublish 23492861 eye201340 10.1038/eye.2013.40 PMC3650283 Curr Opin Pharmacol. 2011 Feb;11(1):59-67 21420906 Acta Ophthalmol. 2012 Mar;90(2):e152-3 21649872 Ophthalmology. 2011 Apr;118(4):730-5 21168223 Eye (Lond). 2007 Sep;21(9):1241-2 17603467 J Cataract Refract Surg. 2005 Dec;31(12):2240-1; author reply 2241 16473184

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2013 Eye

20. Intraoperative floppy iris syndrome (IFIS): what complication rates can we expect? (PubMed)

Intraoperative floppy iris syndrome (IFIS): what complication rates can we expect? 24276563 2014 11 05 2018 12 02 1435-702X 252 5 2014 May Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie Graefes Arch. Clin. Exp. Ophthalmol. Intraoperative floppy iris syndrome (IFIS): what complication rates can we expect? 845-6 10.1007/s00417-013-2536-8 Grzybowski Andrzej A Department of Ophthalmology, Poznan City (...) Hospital, ul. Szwajcarska 3, 61-285, Poznań, Poland, ae.grzybowski@gmail.com. Krzyżanowska-Berkowska Patrycja P eng Letter Comment 2013 11 27 Germany Graefes Arch Clin Exp Ophthalmol 8205248 0721-832X 0 Adrenergic alpha-1 Receptor Antagonists 0 Sulfonamides NW1291F1W8 Doxazosin IM Graefes Arch Clin Exp Ophthalmol. 2013 Jun;251(6):1541-5 23420297 Adrenergic alpha-1 Receptor Antagonists adverse effects Doxazosin adverse effects Female Humans Intraoperative Complications Iris Diseases epidemiology Male

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2013 Graefe's Archive for Clinical and Experimental Ophthalmology

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