Intraoperative floppy iris syndrome in female population

Session Details

Session Title: Cataract Surgery Complications Management. OVDs, Cataract Surgery Equipment

Session Date/Time: Monday 07/09/2015 | 08:00-10:00

Paper Time: 08:06

Venue: Main Auditorium

First Author: : A.Tzamalis GREECE

Co Author(s): :    C. Mpoli   M. Samouilidou   E. Anastasopoulos   N. Chalvatzis   S. Dimitrakos   I. Tsinopoulos     

Abstract Details

Purpose:

To assess the incidence of intraoperative floppy iris syndrome (IFIS) in female patients undergoing phacoemulsification cataract surgery, evaluate risk factors for its appearance, investigate possible associations with medication and report on the final visual outcome.

Setting:

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

Methods:

Female patients with a recorded IFIS of any severity occurring over the last 4 years (March 2011 to February 2015) in a tertiary care ophthalmic centre during phacoemulsification surgery were identified through search in the electronic OP-recording software and enrolled in a multivariate analysis. Their medical records were retrospectively reviewed and, when needed, patients were contacted again to gather further information regarding medication being taken at the time of surgery and contemporary ophthalmic status. Ophthalmic pathologies, clinical data on systemic health status and medications were evaluated as possible risk factors.

Results:

IFIS was observed in 23 out of totally 1937 eyes (1.19%) of 1678 female patients undergoing cataract surgery,whilst the incidence of IFIS in male patients at the same time period was statistically significantly higher (4.75%, 89/1874 eyes, p<0.0001).No bilateral female IFIS cases were recorded and no tamsulosin intake was identified from their medical records. 65.2% of female IFIS subjects suffered from arterial hypertension and 39.1% from anxiety disorders.No ophthalmic conditions (PEX,Glaucoma,Diabetic retinopathy) were found to influence the incidence of IFIS in women(p>0.05).Current use of AT1-receptor antagonists and benzodiazepines were independently associated with IFIS in females (p<0.001, multivariate analysis).Posterior capsular rupture incidence (21.7%) and final visual acuity were shown to correlate positively with the severity grade of IFIS (p<0.01).

Conclusions:

Intraoperative floppy iris syndrome, although rare in female patients, should not be disregarded, as its appearance may significantly increase intraoperative complications rate and affect the final visual outcome. Medical management of arterial hypertension and anxiety disorders with AT1-receptor antagonists and benzodiazepines respectively may lead to IFIS in female subjects, highlighting the need of preoperative drug history awareness so that the surgeon may be prepared to employ appropriate compensatory measures to tackle IFIS.

Financial Interest:

NONE