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Topical 1% atropine and intracameral epinephrine 1:8000 reduces the incidence of intraoperative floppy iris syndrome

Poster Details

First Author: F.Esen TURKEY

Co Author(s):    A. Erdagi-Bulut   E. Toker           

Abstract Details


To evaluate the effectiveness of topical atropine and topical atropine combied with intracameral epinephrine treatment for prophylaxis of intraoperative floppy iris syndrome.


The files of the 533 male cataract patients operated by a single surgeon (ET) were reviewed for the history of the alpha adrenergic antagonists use and 72 eyes of 55 patients were found to be affected by alpha adrenergic antagonists use for benign prostatic hyperplasia.


In all of the patients, systemic alpha antagonist use was discontinued at least 10 days prior to surgery. Standard premedication with topical cyclopentolate, phenilephrine, tropicamide and ketorolac was applied to all of the patients. BSS used during the surgery was routinely supplemented with 1:1000000 epinephrine. In 22 cases no other method was used (Group NP), while in 29 cases topical atropine drops was instilled 12h and 30 min before surgery (Group A) and in 21 cases 1:8000 epinephrine was injected to the anterior chamber at the beginning of surgery (Group EA).


In Group NP, 62.8% of the cases developed IFIS, while development of IFIS was significantly lower in Group A (17.2%, p=0.0004) and Group EA (9.5%, p<0.0001). Posterior capsule rupture was observed in 2 cases (9.1%) in Group NP, in 1 case (3.4%) in Group A and was not observed in Group EA. Transient rise in intraocular pressure was observed in 5 cases (22.7%) in Group NP, in 5 cases (17.2%) in Group A and in 3 cases (14.2%) in Group EA. There was no statistically significant difference between the groups for the above mentioned complications.


Our results indicate that preoperative use of topical atropine reduces the incidence of IFIS in high risk patients. Additional use of epinephrine is associated with a trend for lower incidence of IFIS and related complications.

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