Ifis In Female Patients? Still An Oxymoron?
Published 2025 - 43rd Congress of the ESCRS
Reference: PP11.03 | Type: Free paper | DOI: 10.82333/e6y6-jv77
Authors: David Aragon Aragón Roca* 1 , Elío Díez-Feijóo 2 , Pilar Prats Vidal 3 , Sara Hernández Almeida 4 , Meilin Chang Sotomayor 5 , Abul Barkat Mustafa Ikhlaq 6 , Lena Giralt Peret 7 , Martina Larroude 8 , Nathalie Gutiérrez Lemus 9 , Jesús Costa Vila 3
1Cornea and refractive surgery,Admiravisión,Barcelona,Spain;Cornea department,Hospital del Mar,Barcelona,Spain, 2Cornea and refractive surgery,Admiravisión,Barcelona,Spain;Cornea and refractive surgery,Centro de Oftalmología Bonafonte ,Barcelona,Spain, 3Cornea and refractive surgery,Admiravisión,Barcelona,Spain, 4Glaucoma and refractive surgery,Admiravisión,Barcelona,Spain, 5Cornea and refractive surgery,Admiravisión,Barcelona,Spain;Cornea and cataract surgery,Hospital Clínic,Barcelona,Spain, 6Cornea and refractive surgery,Admiravisión,Barcelona,Spain;Cornea department,Hospital Esperit Sant,Barcelona,Spain, 7Retina and refractive surgery,Admiravisión,Barcelona,Spain;Vitreoretina,Hospital Clínic,Barcelona,Spain, 8Cornea and refractive surgery,Admiravisión,Barcelona,Spain;Cornea,Hospital Josep Trueta,Girona,Spain, 9Glaucoma and refractive surgery,Admiravisión,Barcelona,Spain;Glaucoma and cataract,Hospital Parc Taulí,Sabadell,Spain
Purpose
To evaluate the incidence, characteristics, and outcomes of Intraoperative Floppy Iris Syndrome (IFIS) in female patients undergoing cataract surgery, with a focus on associated risk factors and surgical outcomes.
Setting
IInd Ophthalmology Department, Aristotle University of Thessaloniki,
Single Surgeon Analysis
Methods
A prospective analysis of 350 consecutive cataract surgeries performed by a single surgeon over a 2.5-year period was conducted. IFIS was defined by the presence of intraoperative iris billowing, propensity for iris prolapse, and progressive miosis. Data on patient demographics, preoperative and postoperative best-corrected visual acuity (BCVA), IFIS staging, and medication use were collected and analyzed.
Results
Among female patients, the incidence of IFIS was 7.3% (n=26), with an age range of 53 to 94 years. The mean BCVA improved from 0.4 preoperatively to 0.82 postoperatively in the overall cohort. In IFIS patients, mean BCVA improved from 0.5 preoperatively to 0.67 postoperatively. IFIS staging revealed Stage I in 40% of cases, Stage II in 46.7%, and Stage III in 13.3%. Medication analysis showed that 50% of IFIS patients were using alpha-1 adrenergic receptor antagonists, 35% were on benzodiazepines, 25% on selective serotonin reuptake inhibitors (SSRIs), and 20% on antispasmodics (correlation p,0.005). Notably, 30% of patients reported the use of herbal medications upon detailed history-taking, while 30% were not using any medications
Conclusions
IFIS in female patients, though less common than in males, presents significant intraoperative challenges and is associated with a range of systemic and herbal medications. The condition was observed across all IFIS stages, with a notable proportion of cases occurring in patients without a history of alpha-1 antagonist use. These findings highlight the importance of thorough preoperative medication reviews, including herbal supplements, to identify at-risk patients and optimize surgical outcomes