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M.R. Awan, C.M. G. Cheung, S. Sandramouli; Tamsulosin– Associated Intra–Operative Floppy Iris Syndrome: Prevalence and Its Impact on Phacoemulsification Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2006;47(13):673.
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Intraoperative Floppy Iris Syndrome (IFIS) is a newly recognized syndrome characterized by a triad of: flaccid iris that undulates and billows in response to ordinary intraocular fluid currents, a propensity for the iris to prolapse toward the incisions and progressive intraoperative miosis. There is preliminary suggestion that IFIS is associated with systemic use of tamsulosin hydrochloride (Flomax), a medication commonly prescribed for benign prostatic hypertrophy.
The aim of our study was to determine the prevalence of tamsulosin use among patients undergoing cataract surgery in the United Kingdom and the prevalence of tamsulosin–associated IFIS. We also looked at correlation between the duration of tamsulosin intake and its impact on IFIS.
We prospectively identified patients on tamsulosin from preoperative assessment for cataract surgery. A questionnaire was attached to the patient’s notes where the presence or absence of intraoperative features of IFIS was recorded on the day of surgery.
2390 cataract operations were performed between March and August 2005, of which 17 eyes of 15 patients were on tamsulosin (prevalence: 0.71%). The mean duration of tamsulosin intake was 30 months (range: 3 months to 10 years). Of these 17 eyes, 5 (30%) displayed all three characteristics of IFIS, 6 (35%) displayed some of the characteristics and 6 (35%) did not display any features of IFIS. Iris hooks were used in 2 eyes only. 1 eye was complicated by zonular dehiscence.
Our data showed a lower prevalence of tamsulosin use in the studied UK population and less tamsulosin–associated IFIS than that reported previously. Many eyes did not display any features of IFIS or only manifested partial IFIS. These cases are compatible with phacoemulsification without adjustment of the technique. The duration of tamsulosin intake does not appear to correlate with the severity of IFIS.
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