Intracameral phenylephrine 1.5%. A successful technique for prevention of intra-operative floppy-iris syndrome associated with tamsulosin

Poster Details

First Author: K.Mehta INDIA

Co Author(s):    C. Mehta              

Abstract Details

Purpose:

Step 1 . To assess the efficacy of intracameral phenylephrine (IPH) for prophylaxis against intraoperative floppy iris syndrome (IFIS). Step 2 to analyze the ability of IPH to reverse IFIS.

Setting:

Mehta International Eye Institute.

Methods:

Prospective comparative fellow eye study including 85 eyes of 56 patients receiving tamsulosin who underwent cataract surgery by two surgeons. Random selection done at beginning of surgery to receive either 0.6cc of nonpreserved bisulfite-free IPH 1.5% (Group 1) or balance salt solution (Group 2) at the start of surgery. However if significant miosis (>2mm decrease in pupil diameter) or iris prolapse occurred dur9ing surgery, , IPH was injected during phacoemulsification in group 2. Routine topical mydriatics were instilled before surgery. No changes were performed on the either of the surgeon’s standard fluidics phaco parameters or viscoelastic preferences. A careful check of iris prolapse or intraoperative iris billowing and variabilities in pupil size were recorded.

Results:

No sign of IFS was noted in the IPH injected group. 84% of eyes in group 2 showed some sign of IFIS. Interestingly, iris billowing, instable iris, prolapse that occurred in 64% of eyes in group 2 was successfully reverted with IPH. An analysis of pulse, BP during evaluation showed absolutely no change pre or post IPH injected groups.

Conclusions:

IPH would thus seem to be an important tool for the prophylaxis against IFIS. Its ability to reverse IFIS once occurred and reversion to normalcy makes for far better, safer, easier surgery. FINANCIAL DISCLOSURE?: No