II. Pathophysiology: Intraoperative Floppy Iris Syndrome
- Sudden prolapse and Pupil Constriction in Cataract surgery
- Related to Alpha Adrenergic Antagonist medications
III. Causes
- Specific Alpha-1 adrenergic Antagonists (highest risk)
- Non-specific Alpha Adrenergic Antagonists
- Beta Blockers with Alpha Adrenergic Antagonist activity
- Other agents with alpha-adrenergic Antagonist activity
- Risperidone
- Clorpromazine
- Imipramine
IV. Complications
- Tamsulosin (Flomax) increases the complication risk most significantly (as much as 2.3 times)
- Complications include
- Retinal Detachment
- Lost lens fragment
- Severe iris defects
V. Prevention
- Identify preoperative Cataract patients with any current or prior history of Alpha Adrenergic Antagonist use (even distant use)
- Notify the ophthalmologist performing the procedure of this medication use
- Surgical procedure can be proactively modified for patients on alpha-1 Antagonists
VI. References
- (2012) Presc Lett 19(5): 28
- Chang (2008) J Cataract Refract Surg 34(12): 2153-62 [PubMed]
- Bell (2009) JAMA 301(19): 1991-6 [PubMed]
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Concepts | Pathologic Function (T046) |
ICD9 | 364.81 |
ICD10 | H21.81 |
English | Floppy iris syndrome, floppy iris syndrome, floppy iris syndrome (diagnosis) |
Dutch | floppy iris-syndroom |
German | Floppy Iris Syndrom |
Italian | Sindrome dell'iride a bandiera |
Portuguese | Síndrome de íris hipotónica |
Spanish | Síndrome del iris flácido |
Japanese | 虹彩緊張低下症候群, コウサイキンチョウテイカショウコウグン |
French | Syndrome de l'iris hypotonique |
Czech | Syndrom plovoucí duhovky |
Hungarian | Lebegő (floppy) írisz szindróma |