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M. Calsina, A. Matheu, A. Anton, J. Armentia, M. Castilla; Is Wash Out Period and/or Discovisc Useful to Avoid Intraoperatory Floopy Iris Syndrome. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5458.
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1.- To describe and compare IFIS between eyes operated on after a fifteen and a thirty day wash-out period.2.- To describe and compare IFIS in eyes operated on using with DisCoVisC®.•PATIENTS: This prospective study includes men treated with tamsulosin (>5months) who needed cataract surgery. Exclusion criteria include advanced diabetic retinopaty, pseudoexfoliation, uveitis and topic pilocarpin treatment.•
-Group 1.- 12 eyes (6 patients). One eye operated on after 15 days wash-out. Second eye after 30 days wash-out.-Group 2.- 6 patients had one eye operated on after 15 days wash-out using DisCoVisc® viscoelastic.-Fluidics was set at low rates ( aspiration ≤25 mL/min and vaccuum settings ≤ 250 mmHg)Several intraoperative facts were evaluated: mydriasis preoperatively, midryasis post I/A, iris and pupil reaction,surgical maneuvers needed and intraoperative complications.•
6 eyes - 15-day wash-out period: Preoperative dilatation: 8 mm (phenylephrine + tropicamide thrice).Pupil constriction in all cases (6 mm pupil post I/A).5 cases showed no iris prolapse and low fluctuation. IFIS triad:1 case.No retractors. No complications.1eyes - 30-day wash-out period:Same pupil diameter pre and intraoperatively.No IFIS.6 eyes - 15-wash-out period + DisCoVisc®:Preoperative dilatation: 8 mm (phenylephrine + tropicamide thrice).Less pupil constriction (8-7 mm pupil post I/A).5 cases: No iris prolapse nor fluctuation.IFIS triad :1 case.No retractors. No complications.•
Stopping tamsulosin preoperatively might prevent IFIS.We found no differences between a fifteen and a thirty day wash-out period.We recommend a fifteen day wash-out period, when possible.IFIS appearence and intensity depend on: medication, cataract,fluidics, viscoelastic, and the surgeon experience.DisCoVisc® provides excellent space maintenance during all surgery. It is also very useful in very poorly dilated pupils before surgery.Is able to mantain pupil diameter and reduces iris fluctuation.Fluidics must be set at low rates to reduce the iris billowing and tendency to prolapse.
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