Incidence of Intraoperative Floppy Iris Syndrome in Patients on Either Systemic or Topical [alpha]1-Adrenoceptor Antagonist

Purpose To evaluate the incidence of Intraoperative Floppy Iris syndrome (IFIS) in relation to the usage of 1-adrenoceptor antagonists. Design Prospective, interventional case series. Methods In 2,643 consecutive eyes of 1,968 patients undergoing cataract surgery, occurrence of IFIS and use of 1antagonists were recorded. Results IFIS was observed in 29 eyes (1.1%) of 25 male patients, all of whom were receiving 1antagonists. In those receiving systemic tamsulosin, 1Aselective antagonist, IFIS developed in 25 (43.1%) of 58 eyes. In those receiving systemic naftopidil, 1Aand 1Dantagonists, IFIS was found in 4 (19.0%) of 21 eyes. There was no case of IFIS in patients who received other systemic 1antagonists and in eyes treated with bunazosin eyedrops, a nonselective 1antagonist. Conclusions IFIS occurred in 1.1% of cases treated with systemic 1A-adrenoceptor antagonists for benign prostatic hypertrophy. Topical nonselective 1antagonist did not induce IFIS.