April 2014
Volume 55, Issue 13
ARVO Annual Meeting Abstract  |   April 2014
Risk factors for Intraoperative Floppy Iris Syndrome in Women
Author Affiliations & Notes
  • Komal Joshi
    Ophthalmology, State University of New York Stony Brook, Stony Brook, NY
  • Stephanie Muylaert
    Ophthalmology, State University of New York Stony Brook, Stony Brook, NY
    New York Eye and Ear Infirmary, New York, NY
  • Timothy Chou
    Ophthalmology, State University of New York Stony Brook, Stony Brook, NY
  • Footnotes
    Commercial Relationships Komal Joshi, None; Stephanie Muylaert, None; Timothy Chou, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2801. doi:
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      Komal Joshi, Stephanie Muylaert, Timothy Chou; Risk factors for Intraoperative Floppy Iris Syndrome in Women. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2801.

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      © ARVO (1962-2015); The Authors (2016-present)

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To indentify risk factors for Intraoperative Floppy Iris Syndrome (IFIS) in women.


Case-control study of women undergoing cataract surgery by routine phacoemulsification technique by one surgeon from 2009-2013. Data extraction included demographic information, systemic conditions, medication usage, tobacco usage, clinical exam and intraoperative findings. Statistical analysis was performed using the Fisher’s exact test.


All 35 cases of IFIS that were identified in women who underwent routine cataract surgery during the above time period were included. Thirty-five controls were randomly selected from the surgical case log from the same time frame. The average age of patients with IFIS was 71.6 years and 69.5 years for the control group. Of the 35 IFIS cases, 20% had severe IFIS (iris billowing or floppiness, iris prolapse, and miosis), 34.3% had moderate IFIS (Iris billowing with miosis or prolapse) and 45.7% had mild IFIS (billowing without miosis or prolapse). Hypertension was present in 54.2% of IFIS patients, compared to 69.2% of controls (p= 0.62). Tobacco use was noted in 31.4% of IFIS patients, whereas only 20% of controls used tobacco (p=0.41). Two patients in the IFIS group were on alpha-1 antagonist (5.7%) and none in the control group (p=0.49). Finally, 22.9% of IFIS patients had a prior laser peripheral iridotomy (LPI), compared to only 2.9% of controls (p=0.028). There were 2 patients with no systemic conditions or medication usage that had severe IFIS.


IFIS can occur in female patients during routine cataract surgery. History of prior LPI is a possible risk factor for IFIS in women. While there were a higher percentage of tobacco and alpha-1 antagonist users in the IFIS group, these differences were not statistically significant. Hypertension was not found to be a statistically significant risk factor in this study.

Keywords: 571 iris • 445 cataract • 667 pupil  

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