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P. Joseph, J.Y. Kim, B. Henderson, S.L. Cremers; Report of Tamsulosin Linked Intraoperative Floppy Iris Syndrome (IFIS) Incidence, Associated Complications, and Visual Outcomes in the Large Residents’ Cataract–Outcomes Database, OASIS . Invest. Ophthalmol. Vis. Sci. 2006;47(13):672.
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To investigate the incidence of IFIS in the OASIS database and identify associated intra–operative complications linked to systemic alpha–1 antagonists (Tamsulosin, Flomax®) and final post–operative vision outcomes.
A large database of resident surgery performed at the Harvard Medical School’s Department of Ophthalmology Comprehensive Service was used to identify the percentage of patients on systemic alpha–1 antagonist medications. All cases were compared to age and time matched controls that were not on a systemic alpha–1 antagonists. A separate subset of age matched pseudoexfoliation (PXF) patients (not on Tamsulosin) was also evaluated for comparison. Pearson Chi square test was used to compare the rates of small pupil, need for iris hooks, IFIS, posterior capsular tear (PCT) and vitreous loss between the groups. In addition, Mann–Whitney test was used to compare the visual outcomes of the 3 groups.
0.46% ( 8/1746 ) of the patients in the OASIS database were taking Tamsulosin for BPH. 4.8% (84/1746) of patients had PXF. The respective percentages of small pupil, need for iris hooks, IFIS, and PCT for each group were as follows:
There was no significant difference in pre operative best corrected visual acuity (BCVA) of patients in the 3 groups, but the patient group on Tamsulosin showed a significantly poor visual outcome(defined as final BCVA subtracted by preoperative BCVA) at post–op month 3 and 6 compared to the control (p< 0.001) and PXF (p<0.001) groups.
IFIS occurred in approximately 25% of patients taking Tamsulosin at the time of cataract surgery, and is associated with a poor visual outcome when compared to the controls and pseudoexfoliation group.
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