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The influence of dilated pupil diameter on intraoperative floppy iris syndrome

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First Author: A.Tzamalis GREECE

Co Author(s):    C. Christou   A. Mataftsi   I. Tsinopoulos   N. Ziakas           

Abstract Details

Purpose:

To investigate the impact of dilated pupil diameter (PD) as a risk factor for the appearance of Intraoperative Floppy Iris Syndrome (IFIS) and its correlation with intra- and postoperative complications in cataract surgery.

Setting:

2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece

Methods:

1178 cataract patients undergoing phacoemulsification surgery with or without a recorded IFIS of any severity occurring over the last year in a tertiary care ophthalmic center were identified and enrolled in a multivariate analysis. Possible predisposing risk factors for the appearance of IFIS were thoroughly recorded in each case and pupil size after pharmacologic dilation was measured one week preoperatively.

Results:

IFIS was observed in 44 out of totally 1294 eyes (3.4%) undergoing cataract surgery, whilst the incidence of IFIS in male patients was significantly higher than in women (6.03% vs 1.15%, p<0.0001). Preoperative PD was statistically significantly lower in cases that developed IFIS (PDIFIS=6.23±1.4mm vs PDNON-IFIS=7.38±0.9mm, p<0.001), a difference that remained significant in patients receiving a1-blockers for benign prostate hyperplasia (PDIFIS=5.86±1.5mm vs PDNON-IFIS=6.78±0.9mm, p=0.01). Logistic regression analysis revealed that PD and a1-blockers intake were the only significant risk factors for the appearance of IFIS (p<0.001), while PD was negatively correlated with posterior capsular rupture and iris trauma rates (p=0.03 and P<0.001 respectively).

Conclusions:

The size of preoperative pupillary dilation seems to have a significant impact on the appearance of floppy iris and could be used as a predictive measure by surgeons in order to minimize the potentially catastrophic consequences of unforeseen IFIS.

Financial Disclosure:

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