Floppy Iris Syndrome

Science is always battling to understand all aspects of the human eye, and in turn, ophthalmologists are constantly discovering and learning about new developments, diseases and conditions. Some of these findings come to the surface during normal surgical procedures such as cataract surgery, in this particular case. Although, this syndrome is a rare occurrence among cataract removal, it is something that should be on ophthalmologist’s radar for possible complications.


What is Floppy Iris Syndrome


Intra-operative floppy iris syndrome (IFIS) is a possible, rare occurrence that can happen during a routine cataract surgery. This complication arises when the loose hanging iris swells up in reaction to the flow of intra-ocular fluids, while they move from the front to the back chambers of the eye. This can also result in the iris to fall forward in the direction of the removal site of the cataract. IFIS is a condition not currently well known by most ophthalmologist, due to its rarity.


Causes of Floppy Iris Syndrome


IFIS more commonly occurs in patients undergoing cataract removal surgery who are on specific types of medications. According Leonid Skorkin, Jr., O.D., D.O., in his article, “How to Avoid Intraoperative Floppy Disk Syndrome”, medications such as Flomax, Rapaflo, Cardura and Hydrin have been found to cause IFIS more frequently in patients undergoing this surgical procedure. Although not all medications that cause IFIS have been identified, findings show men being treated for Benign Prostatic Hyperplasia (BPH) and women with urinary hesitancy or retention, are at the top of the list.


Prevention and Treatment


One of the biggest ways to counteract the possibility of IFIS happening during cataract surgery, is informing the ophthalmic surgeon of the medications the patient is currently on. By being informed of this potential complication, the surgeon will be aware of what signs to look for in order to best treat IFIS. IFIS is ultimately prevented and treated the same way, with specific tools and chemical agents. Tools such as iris hooks, retractors and expanders, help keep the pupil from retracting and stay in the correct spot for the surgical procedure.


Although scientist and physicians don’t know all causes for this particular syndrome, they will continue conducting studies to find the medications that can trigger this type of response, in a surgical procedure. Every time a patient goes to their doctor’s office, whether it be eye, dental, health, etc., it’s best practice to inform them about any and all medications they are currently on. This transparency could help tremendously during what doctors and patients describe to be a routine surgical procedure.

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