Intraoperative Floppy Iris Syndrome In Women: Prevalence And Association With Ocular And General Medication Use

Intraoperative Floppy Iris Syndrome (IFIS) is historically linked to alpha-1 receptor blockers in men. Despite initial focus on males, IFIS occurs in women, yet gender-specific prevalence and its medication associations remain underexplored. In this study we investigate IFIS prevalence in women and its potential links to current systemic and eye medication.

Dardenne Eye Hospital, Bonn, Germany

This retrospective, comparative, monocentric study analyzed medical records of patients undergoing cataract surgery from January 2018 to June
2022. Data included ocular/systemic comorbidities and current ocular and systemic medication use, classified using Anatomical Therapeutic Chemical (ATC) coding. Data was also extracted in an age- and gender-matched control group without IFIS. We used SPSS software and the Chi-square test for statistical analyses. IOP-lowering drops were categorized into beta blockers, carbonic anhydrase inhibitors, alpha agonists, and prostaglandin analogues.

We identified 163 eyes of 149 women with IFIS. The mean age was 76.9 years (Range: 52 - 95). The prevalence of IFIS in women was 6.3% (163
out of 2593 eyes), contrasting with 20.3% in men (431 out of 2121). Comparison of systemic medication usage between IFIS cases and controls showed no
significant differences in women. The utilization of IOP-lowering drops was higher in the female IFIS group compared to the matched cohort (13.5% vs. 7%, p=0.064), although this difference did not reach statistical significance.

This study offers gender-specific IFIS prevalence data and suggests no current systemic medication association with its occurrence in women.
Remarkably, the prevalence in women is approximately one-third of that observed in men. We noted a tendency towards a greater prevalence of IOP-lowering drops in the female IFIS group.