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Intraoperative floppy iris syndrome (IFIS): epidemiology and risk factors

Poster Details

First Author: T.Vachtsevanos GREECE

Co Author(s):    E. Karakosta   L. Kazantzidis   T. Topalidis   D. Tsakpinis   E. Kaldi  

Abstract Details


Intraoperative floppy iris syndrome (IFIS) is characterized by a billowing iris, insufficient pupillary dilation with progressive intraoperative miosis, and protrusion of iris tissue through the incisions that are made during cataract surgery in certain patients, associated widely with medications prescribed for benign prostatic hyperplasia (BPH). To assess the incidence, and identify medications associated with IFIS in patients undergoing cataract surgery.


Ophthalmology clinic, Ā«O Agios DimitriosĀ» General Hospital of Thessaloniki


Cataract patients operated between January 2015 and October 2015 (1667 eyes) were evaluated to assess incidence of IFIS and to determine medications associated with IFIS. At the time of admission medical history, current and past medication use were collected. IFIS was defined by the reported presence of any of the three signs that constitutes the syndrome. Suspicion of IFIS was defined by the presence of incidents directly related to an abnormal behavior of the iris. The pupillary constriction, the prolapse of the iris, surgical time and any complications were recorded.


The overall incidence of IFIS was 7,4% (123 of 1667 eyes). Complete IFIS in presence of full triad of characteristic intraoperative features was 3% (51 of 1667 eyes) and 4,3% (72 of 1667) to incomplete IFIS. The highest prevalence of IFIS was in patients exposed to Tamsulosin (38%). In other medications prevalence of IFIS were: Alfuzosin 19%, Finasteride 14%, Doxazosin 15% and Carvedilol 11% and benzodiazepines (3%). IFIS occurs statistically more often in patients exposed to Tamsulosin. The occurrence was associated with higher surgical times and with the severity and grade of IFIS.


In conclusion, due to presence of IFIS patients treated for benign prostatic hypertrophy, hypertension and anxiety disorders may have increased risk of complications during cataract surgery. Patients should be informed about potential risks so that it can be discuss with their healthcare providers, in particular urologist and ophthalmologist, prior to cataract surgery. FINANCIAL DISCLOUSRE: NONE

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