China
Africa
Explore chapters and articles related to this topic
Common/useful drugs
Published in Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson, Pocket Prescriber Psychiatry, 2019
Jonathan P Rogers, Cheryl CY Leung, Timothy RJ Nicholson
Caution: cataract surgery (risk of intraoperative floppy iris syndrome), GI obstruction risk, prolactin-dependent tumours, Parkinson's/Lewy body dementia, jaundice, ↑prostate, severe respiratory disease, glaucoma (angle-closure), R/H/E (with dementia or risk factors for stroke).
Combined Cataract and Glaucoma Surgery
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Arvind Neelakantan, Mary Fran Smith, Maher M. Fanous, Mark B. Sherwood
Intraoperative floppy iris syndrome occurs in patients on systemic alpha-1 blockers and has been known to occur even if these medications have been stopped weeks or months or even longer preoperatively. The lack of tone causes the iris to billow in response to the normal irrigation currents in the anterior chamber during phacoemulsification, and these irides have a marked propensity to prolapse through the clear corneal incision sites. Progressive pupil constriction also occurs during surgery. Use of intracameral preservative-free, bisulphite-free, 1:1000 epinephrine (diluted with preservative-free lidocaine or BSS) can help dilate the pupil in these cases. IFIS is best managed by preoperative anticipation and employing methods of small pupil management described above prior to starting the capsulorrhexis.
Risk factors of floppy iris syndrome: current insights
Published in Expert Review of Ophthalmology, 2021
Argyrios Tzamalis, Chrysanthos D. Christou, Ioannis Tsinopoulos, Nikolaos Ziakas
Intraoperative Floppy Iris Syndrome has been a subject of research and a topic of discussion among ophthalmologists in the past fifteen years. Although most cataract surgeons are aware of IFIS possibility in male patients receiving alpha-1 blockers for BPH, they still lack awareness regarding other risk factors that may lead to the development of floppy iris. It is of note that, especially in women, where most surgeons do not anticipate the appearance of IFIS, intraoperative complications are significantly increased, influencing the final visual outcome, as we have already reported in one of our previous studies [9]. Therefore, stratifying the surgical risk preoperatively, identifying high-risk patients, and employing preventive measures and modified surgical strategies is the key to addressing IFIS [64].
Increased pupil diameter is a protective factor against intraoperative floppy‐iris syndrome
Published in Clinical and Experimental Optometry, 2020
Ioanna Mylona, Maria Dermenoudi, Nikolaos Ziakas, Ioannis Tsinopoulos
Chang and Campbell were the first authors to describe intraoperative floppy‐iris syndrome (IFIS) in 2005 as a syndrome affecting patients undergoing routine phacoemulsification who present with a tendency for poor pupil dilation, and a triad of intraoperative signs including billowing of a flaccid iris stroma, propensity for iris prolapse toward the phaco and side‐port incisions, and progressive intraoperative pupil constriction.2005 While the incidence and severity of IFIS is variable, the syndrome has been associated with the use of systemic α1‐antagonists, and with a higher rate of cataract surgical complications, especially when the condition is not recognised or anticipated.2008 A meta‐analysis that investigated the relative effect of different α1‐antagonists concluded that the pooled odds ratio for IFIS after tamsulosin use was approximately 40‐fold greater (or 16.5 at the alternative analysis) than that after alfuzosin or terazosin.2011 Hypertension was also the only other significant risk factor in a recent prospective study while duration of α‐blockers intake was not found to be associated with IFIS.2016
Atropine in topical formulations for the management of anterior and posterior segment ocular diseases
Published in Expert Opinion on Drug Delivery, 2021
Ines García Del Valle, Carmen Alvarez-Lorenzo
Intraoperative floppy iris syndrome, also known as IFIS, hastens complications during phacoemulsification and it is distinguished by three key features: fluttering and billowing of iris stroma in response to normal fluid currents, progressive pupil constriction during surgery, and propensity of iris prolapse to phaco and side-port incisions. Once patients with floppy iris syndrome are identified, surgical and medical techniques are available at different points of the intervention to decrease this condition and its inherent risks. These approaches include preoperative use of atropine, intraoperative intracameral use of epinephrine or phenylephrine, and intraoperative modifications such as iris retractors, dilator rings, or ophthalmic viscosurgical devices [63,65].