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Management of intra-operative floppy-iris syndrome in cataract surgery: a randomised study

Session Details

Session Title: Cataract I

Session Date/Time: Friday 14/02/2014 | 10:30-12:30

Paper Time: 11:00

Venue: Kosovel Hall (Level -2)

First Author: : MariaWeber AUSTRIA

Co Author(s): :    Sophie Mädel   Petra Draschl   Nino Hirnschall   Oliver Findl     

Abstract Details


To evaluate the influence of a standard cohesive ophthalmic viscoelastic device (OVD) in comparison to a viscoadaptive OVD in eyes at risk of intra-operative floppy-iris syndrome on intra-operative complications, pupil size and post-operative inflammation.


Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna


This randomised trial included patients who were scheduled for cataract surgery and who have been taking alpha-1 adrenergic receptor antagonists such as tamsulosin. Eyes were allocated to a standard cohesive OVD (Healon, Abott Medical Optics, USA; group A), or a visco-adaptive OVD (Eyefill S.C., Croma Pharma, Austria; group B) The OVD was used to stabilize the iris and viscodilate the pupil during phacoemulsification. The rescue strategy was the use of iris hooks in case of the pupil becoming too small. Intra-operative complications such as iris prolapse as well as pupil size during all steps of surgery were documented. Aqueous flare was measured pre-operatively, 1 hour, 1 day and 1 month post-operatively with the Laser Flare Meter FM-600 (Kowa, Japan). Additionally central corneal thickness (CCT) and intra-ocular pressure (IOP) were assessed.


Fourty eyes of 40 patients were included. In none of the eyes iris retractors had to be used. Mean aqueous flare pre-operatively, 1 hour, 1 day and 1 month post-operatively in group A and in group B were 4.2 pc/ms (SD: 2.0; range: 1.6 to 9.2), 16.9 pc/ms (SD: 15.1; range:4.6 to 66.9), 6.7 pc/ms (SD: 4.6; range: 1.8 to 17.7) and 5.9 pc/ms(SD: 4.5; range: 1.5 to 17.7) and 5.5 pc/ms (SD: 2.2; range: 2.2 to 10.6), 27.3 pc/ms (SD: 28.3, range: 7.7-138.2), 9.4 pc/ms (SD: 9.0; range: 3.6 to 43.0) and 5.7 pc/ms (SD: 3.1; range: 1.2 to 13.0), respectively. These differences were not found to be significant (p= 0.10; p=0.49; p=0.37; p=0.91). Mean CCT 1 hour post-operatively in group A and in group B was 578 µm (SD: 64; range: 435 to 660) and 596 µm (SD: 47, range: 492 to 664), respectively (p=0.45). Mean IOP measured 1 hour post-operatively was 19 mmHg (SD: 8; range: 10 to 40) in group A and 20 mmHg (SD: 9; range: 10 to 52) in group B (p=0.89). Pupil size results will be presented.


In eyes at risk of intra-operative floppy-iris syndrome no significant differences in post-operative aqueous flare values were found when using a standard cohesive OVD in comparison to the use of a viscoadaptive OVD. FINANCIAL INTEREST: NONE