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Impact of stopping alpha-1 adrenergic antagonists used in the treatment of benign prostate hyperplasia on the severity of intraoperative floppy iris syndrome (IFIS) during cataract surgery

Poster Details

First Author: N.Ondrova CZECH REPUBLIC

Co Author(s):    J. Cendelin                    

Abstract Details


To evaluate the effectiveness of stopping alpha-1 adrenergic antagonists used in the treatment of benign prostate hyperplasia before cataract surgery on severity of IFIS.


Ophthalmology clinic of the 2nd Medical Faculty, Charles University in Prague, and the Faculty Hospital Motol, Centre of eye microsurgery Ofta, Pilsen


Study examining the course of cataract surgery complicated by IFIS in patients with history of benign prostate hyperplasia treated with alpha-1 adrenergic antagonists, in one eye without interrupting the chronic medication, in the following eye stopping the therapy for either one week or two weeks. The results include 30 eyes of 15 patients. We evaluated pupil diameter at the beginning of the operation after the instillation of mydriatic drops, after every stage of surgery and at the end of the operation. Furthermore we evaluated the number of iris prolapses, and iris aspirating into the phaco port and the aspiration cannula.


The statistical analysis of the gathered data cannot prove that stopping alpha1adrenergic antagonists before cataract surgery significantly improves mydriasis and its stability during surgery. In the eye where medication was stopped, diameter of the pupil was larger at the beginning of the surgery and after hydrodissection in 53% of patients, after irrigation/aspiration and at the end in 33% of the patients and after phacoemulsification and IOL implantation in 26% of the patients. Number of iris prolapses and aspirations was higher in group where the medication was stopped- total of 22 prolapses compared to 14 in the eyes with the medication.


Stopping the alpha1-antagonists in the therapy of benign prostate hyperplasia does not improve the mydriasis and its stability during cataract surgery complicated with IFIS. At the same time stopping the therapy might aggravate the symptoms of BHP in these patients.

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