Cataract Surgery Features In Patients With Intraoperative Floppy Iris Syndrome In A Tertiary Eye Center In 2022
Published 2023 - 41st Congress of the ESCRS
Reference: PP19.14 | Type: Free paper | DOI: 10.82333/c6j0-4b35
Authors: Fidan Aghayeva* 1 , Otmar Ringhofer 2 , Abdelrahman Assaf 1 , Ines Lanzl 1
1Technical University of Munick,Munick,Germany;Chiemsee Augen Tagesklinik,Prien am Chiemsee,Germany, 2Chiemsee Augen Tagesklinik,Prien am Chiemsee,Germany
Purpose
This study aims to evaluate characteristics such as clinical efficacy and complications of small incision cataract surgery in patients with intraoperative floppy iris syndrome (IFIS).
Setting
A retrospective chart review of 330 patients (591 eyes) with different grades of cataract and IFIS, who were naïve to any previous intraocular procedures and underwent small incision cataract surgery between January 2022 and January 2023 in Chiemsee Eye Clinic, Germany, was performed.
Methods
Study outcomes were preoperative anterior chamber depth (ACD), pupil diameter (PD), intraoperative ultrasound time (UST), intra- and postoperative complication (IOC and POC) rate during 3 months follow-up.
Results
The mean age of patients was 73.5±8.8 years. Prior medication use was reported in 52.1% patients (Tamsulosin), 26.4% (other alpha-1 antagonists), and 21.5% have been reported without any treatment with alpha blockers. The following median parameters in the operated eyes were found: ACD - 125 (103-152) mm3, PD - 2.53 (2.21-2.99) mm and UST - 4.5 (2.4-6.8) sec. All the implanted intraocular lenses were acrylic plate-haptic lenses: monofocal (81.2%), toric (13.2%), EDOF (2%), and EDOF toric (3.6%) lenses. IOC were noted in 6.4% (iris catching) and in 0.3% (posterior capsule rupture) cases. POC included: 2.5% (anterior uveitis), 26.7% (transitory ocular hypertension), 4.6% (iris transillumination defect), and 13.2% (Irvine–Gass syndrome).
Conclusions
This study shows good clinical efficacy and low complication rate of small incision cataract surgery, even in patients with advanced IFIS. No statistically significant relations between the PD and the UST were found. Although IFIS during phacoemulsification surgery still remains a challenge for cataract surgeons, a comprehensive preoperative examination allows for the properly planned use of intraoperative IFIS management strategies with improved outcomes, prevention of complications, and moreover, implantation of premium intraocular lenses in these complicated eyes.