Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome
Purpose To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery. Methods Prospective cohort study of 55 patients with α 1 -adrenergic receptor antagonist (α 1 -ARA) treatment and 55...
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| Veröffentlicht in: | Graefe's archive for clinical and experimental ophthalmology 2024, Vol.262 (1), p.103-111 |
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| creator | Paschon, Karin Szegedi, Stephan Weingessel, Birgit Fondi, Klemens Huf, Wolfgang Vécsei-Marlovits, Pia Veronika |
| description | Purpose
To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery.
Methods
Prospective cohort study of 55 patients with α
1
-adrenergic receptor antagonist (α
1
-ARA) treatment and 55 controls undergoing cataract surgery. Anterior segment optical coherence tomography (AS-OCT), video pupilometer, and biometry measurements were performed preoperatively and analyzed regarding anatomic parameters that corresponded with a higher rate of IFIS. Those statistically significant parameters were evaluated with logistic regression analysis and receiver operating characteristic (ROC) curve.
Results
Pupil diameter was significantly smaller in patients who developed IFIS compared to those who did not develop IFIS (AS-OCT 3.29 ± 0.85 vs. 3.63 ± 0.68,
p
= 0.03; Pupilometer 3.56 ± 0,87 vs. 3.95 ± 0.67,
p
= 0.02). Biometric evaluation revealed shallower anterior chambers in the IFIS group (ACD 3.12 ± 0.40 vs. 3.32 ± 0.42,
p
= 0.02). Cutoff values for 50% IFIS probability (
p
= 0.5) were PD = 3.18 mm for pupil diameter and ACD = 2.93 mm for anterior chamber depth. ROC curves of combined parameters were calculated for α
1
-ARA medication with pupil diameter and anterior chamber depth, which yielded an AUC of 0.75 for all IFIS grades.
Conclusion
The combination of biometric parameters with history of α
1
-ARA medication can improve assessment of risk stratification for IFIS incidence during cataract surgery. |
| doi_str_mv | 10.1007/s00417-023-06165-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2854429354</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2917680326</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-6f2249e21c22ce7bf418b1cafeccfb2f6152687a133b66eafa7525a7a27b9c1d3</originalsourceid><addsrcrecordid>eNp9kU1r3DAQhkVpabZp_0AOwdBLL26lkS15jyGkHxBoDy3kJmTtKCjYlqqRA_vvq82mDeTQkwR65tHwvoydCf5RcK4_Eeed0C0H2XIlVN_KF2wjOtm3msPNS7bhGkQ7SLg5YW-I7njlZS9esxOpOxgAxIb5HzlSQlfCPTZ2sdOeAjXRH-4lzsE1Hm1ZM1KTMu4CpUhhuW2SLQGXQk2JTVhKtjFhtg8WP8WU9k3IVUT7ZZfjjG_ZK28nwneP5yn79fnq5-XX9vr7l2-XF9etk6BKqzxAt0UQDsChHn0nhlE469E5P4JXogc1aCukHJVC663uobfagh63TuzkKftw9KYcf69IxcyBHE6TXTCuZGDouw62su8q-v4ZehfXXBOo1FZoNfC6UqXgSLmaE2X0JuUw27w3gptDC-bYgqktmIcWjKxD54_qdZxx92_kb-wVkEeA6tNyi_np7_9o_wAyUZT9</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2917680326</pqid></control><display><type>article</type><title>Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Paschon, Karin ; Szegedi, Stephan ; Weingessel, Birgit ; Fondi, Klemens ; Huf, Wolfgang ; Vécsei-Marlovits, Pia Veronika</creator><creatorcontrib>Paschon, Karin ; Szegedi, Stephan ; Weingessel, Birgit ; Fondi, Klemens ; Huf, Wolfgang ; Vécsei-Marlovits, Pia Veronika</creatorcontrib><description>Purpose
To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery.
Methods
Prospective cohort study of 55 patients with α
1
-adrenergic receptor antagonist (α
1
-ARA) treatment and 55 controls undergoing cataract surgery. Anterior segment optical coherence tomography (AS-OCT), video pupilometer, and biometry measurements were performed preoperatively and analyzed regarding anatomic parameters that corresponded with a higher rate of IFIS. Those statistically significant parameters were evaluated with logistic regression analysis and receiver operating characteristic (ROC) curve.
Results
Pupil diameter was significantly smaller in patients who developed IFIS compared to those who did not develop IFIS (AS-OCT 3.29 ± 0.85 vs. 3.63 ± 0.68,
p
= 0.03; Pupilometer 3.56 ± 0,87 vs. 3.95 ± 0.67,
p
= 0.02). Biometric evaluation revealed shallower anterior chambers in the IFIS group (ACD 3.12 ± 0.40 vs. 3.32 ± 0.42,
p
= 0.02). Cutoff values for 50% IFIS probability (
p
= 0.5) were PD = 3.18 mm for pupil diameter and ACD = 2.93 mm for anterior chamber depth. ROC curves of combined parameters were calculated for α
1
-ARA medication with pupil diameter and anterior chamber depth, which yielded an AUC of 0.75 for all IFIS grades.
Conclusion
The combination of biometric parameters with history of α
1
-ARA medication can improve assessment of risk stratification for IFIS incidence during cataract surgery.</description><identifier>ISSN: 0721-832X</identifier><identifier>EISSN: 1435-702X</identifier><identifier>DOI: 10.1007/s00417-023-06165-3</identifier><identifier>PMID: 37428221</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adrenergic alpha-1 Receptor Antagonists - adverse effects ; Adrenergic receptors ; Anterior chamber ; Biometrics ; Cataract ; Cataract - complications ; Eye surgery ; Humans ; Intraoperative Complications - diagnosis ; Iris ; Iris Diseases - chemically induced ; Iris Diseases - diagnosis ; Medicine ; Medicine & Public Health ; Ophthalmology ; Patients ; Phacoemulsification - adverse effects ; Prospective Studies ; Risk assessment ; Statistical analysis ; Sulfonamides ; Surgery ; Tamsulosin</subject><ispartof>Graefe's archive for clinical and experimental ophthalmology, 2024, Vol.262 (1), p.103-111</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-6f2249e21c22ce7bf418b1cafeccfb2f6152687a133b66eafa7525a7a27b9c1d3</cites><orcidid>0000-0002-1110-0432</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00417-023-06165-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00417-023-06165-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37428221$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paschon, Karin</creatorcontrib><creatorcontrib>Szegedi, Stephan</creatorcontrib><creatorcontrib>Weingessel, Birgit</creatorcontrib><creatorcontrib>Fondi, Klemens</creatorcontrib><creatorcontrib>Huf, Wolfgang</creatorcontrib><creatorcontrib>Vécsei-Marlovits, Pia Veronika</creatorcontrib><title>Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome</title><title>Graefe's archive for clinical and experimental ophthalmology</title><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><description>Purpose
To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery.
Methods
Prospective cohort study of 55 patients with α
1
-adrenergic receptor antagonist (α
1
-ARA) treatment and 55 controls undergoing cataract surgery. Anterior segment optical coherence tomography (AS-OCT), video pupilometer, and biometry measurements were performed preoperatively and analyzed regarding anatomic parameters that corresponded with a higher rate of IFIS. Those statistically significant parameters were evaluated with logistic regression analysis and receiver operating characteristic (ROC) curve.
Results
Pupil diameter was significantly smaller in patients who developed IFIS compared to those who did not develop IFIS (AS-OCT 3.29 ± 0.85 vs. 3.63 ± 0.68,
p
= 0.03; Pupilometer 3.56 ± 0,87 vs. 3.95 ± 0.67,
p
= 0.02). Biometric evaluation revealed shallower anterior chambers in the IFIS group (ACD 3.12 ± 0.40 vs. 3.32 ± 0.42,
p
= 0.02). Cutoff values for 50% IFIS probability (
p
= 0.5) were PD = 3.18 mm for pupil diameter and ACD = 2.93 mm for anterior chamber depth. ROC curves of combined parameters were calculated for α
1
-ARA medication with pupil diameter and anterior chamber depth, which yielded an AUC of 0.75 for all IFIS grades.
Conclusion
The combination of biometric parameters with history of α
1
-ARA medication can improve assessment of risk stratification for IFIS incidence during cataract surgery.</description><subject>Adrenergic alpha-1 Receptor Antagonists - adverse effects</subject><subject>Adrenergic receptors</subject><subject>Anterior chamber</subject><subject>Biometrics</subject><subject>Cataract</subject><subject>Cataract - complications</subject><subject>Eye surgery</subject><subject>Humans</subject><subject>Intraoperative Complications - diagnosis</subject><subject>Iris</subject><subject>Iris Diseases - chemically induced</subject><subject>Iris Diseases - diagnosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Ophthalmology</subject><subject>Patients</subject><subject>Phacoemulsification - adverse effects</subject><subject>Prospective Studies</subject><subject>Risk assessment</subject><subject>Statistical analysis</subject><subject>Sulfonamides</subject><subject>Surgery</subject><subject>Tamsulosin</subject><issn>0721-832X</issn><issn>1435-702X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1r3DAQhkVpabZp_0AOwdBLL26lkS15jyGkHxBoDy3kJmTtKCjYlqqRA_vvq82mDeTQkwR65tHwvoydCf5RcK4_Eeed0C0H2XIlVN_KF2wjOtm3msPNS7bhGkQ7SLg5YW-I7njlZS9esxOpOxgAxIb5HzlSQlfCPTZ2sdOeAjXRH-4lzsE1Hm1ZM1KTMu4CpUhhuW2SLQGXQk2JTVhKtjFhtg8WP8WU9k3IVUT7ZZfjjG_ZK28nwneP5yn79fnq5-XX9vr7l2-XF9etk6BKqzxAt0UQDsChHn0nhlE469E5P4JXogc1aCukHJVC663uobfagh63TuzkKftw9KYcf69IxcyBHE6TXTCuZGDouw62su8q-v4ZehfXXBOo1FZoNfC6UqXgSLmaE2X0JuUw27w3gptDC-bYgqktmIcWjKxD54_qdZxx92_kb-wVkEeA6tNyi_np7_9o_wAyUZT9</recordid><startdate>2024</startdate><enddate>2024</enddate><creator>Paschon, Karin</creator><creator>Szegedi, Stephan</creator><creator>Weingessel, Birgit</creator><creator>Fondi, Klemens</creator><creator>Huf, Wolfgang</creator><creator>Vécsei-Marlovits, Pia Veronika</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1110-0432</orcidid></search><sort><creationdate>2024</creationdate><title>Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome</title><author>Paschon, Karin ; Szegedi, Stephan ; Weingessel, Birgit ; Fondi, Klemens ; Huf, Wolfgang ; Vécsei-Marlovits, Pia Veronika</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-6f2249e21c22ce7bf418b1cafeccfb2f6152687a133b66eafa7525a7a27b9c1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adrenergic alpha-1 Receptor Antagonists - adverse effects</topic><topic>Adrenergic receptors</topic><topic>Anterior chamber</topic><topic>Biometrics</topic><topic>Cataract</topic><topic>Cataract - complications</topic><topic>Eye surgery</topic><topic>Humans</topic><topic>Intraoperative Complications - diagnosis</topic><topic>Iris</topic><topic>Iris Diseases - chemically induced</topic><topic>Iris Diseases - diagnosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Ophthalmology</topic><topic>Patients</topic><topic>Phacoemulsification - adverse effects</topic><topic>Prospective Studies</topic><topic>Risk assessment</topic><topic>Statistical analysis</topic><topic>Sulfonamides</topic><topic>Surgery</topic><topic>Tamsulosin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paschon, Karin</creatorcontrib><creatorcontrib>Szegedi, Stephan</creatorcontrib><creatorcontrib>Weingessel, Birgit</creatorcontrib><creatorcontrib>Fondi, Klemens</creatorcontrib><creatorcontrib>Huf, Wolfgang</creatorcontrib><creatorcontrib>Vécsei-Marlovits, Pia Veronika</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paschon, Karin</au><au>Szegedi, Stephan</au><au>Weingessel, Birgit</au><au>Fondi, Klemens</au><au>Huf, Wolfgang</au><au>Vécsei-Marlovits, Pia Veronika</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome</atitle><jtitle>Graefe's archive for clinical and experimental ophthalmology</jtitle><stitle>Graefes Arch Clin Exp Ophthalmol</stitle><addtitle>Graefes Arch Clin Exp Ophthalmol</addtitle><date>2024</date><risdate>2024</risdate><volume>262</volume><issue>1</issue><spage>103</spage><epage>111</epage><pages>103-111</pages><issn>0721-832X</issn><eissn>1435-702X</eissn><abstract>Purpose
To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery.
Methods
Prospective cohort study of 55 patients with α
1
-adrenergic receptor antagonist (α
1
-ARA) treatment and 55 controls undergoing cataract surgery. Anterior segment optical coherence tomography (AS-OCT), video pupilometer, and biometry measurements were performed preoperatively and analyzed regarding anatomic parameters that corresponded with a higher rate of IFIS. Those statistically significant parameters were evaluated with logistic regression analysis and receiver operating characteristic (ROC) curve.
Results
Pupil diameter was significantly smaller in patients who developed IFIS compared to those who did not develop IFIS (AS-OCT 3.29 ± 0.85 vs. 3.63 ± 0.68,
p
= 0.03; Pupilometer 3.56 ± 0,87 vs. 3.95 ± 0.67,
p
= 0.02). Biometric evaluation revealed shallower anterior chambers in the IFIS group (ACD 3.12 ± 0.40 vs. 3.32 ± 0.42,
p
= 0.02). Cutoff values for 50% IFIS probability (
p
= 0.5) were PD = 3.18 mm for pupil diameter and ACD = 2.93 mm for anterior chamber depth. ROC curves of combined parameters were calculated for α
1
-ARA medication with pupil diameter and anterior chamber depth, which yielded an AUC of 0.75 for all IFIS grades.
Conclusion
The combination of biometric parameters with history of α
1
-ARA medication can improve assessment of risk stratification for IFIS incidence during cataract surgery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>37428221</pmid><doi>10.1007/s00417-023-06165-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1110-0432</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0721-832X |
| ispartof | Graefe's archive for clinical and experimental ophthalmology, 2024, Vol.262 (1), p.103-111 |
| issn | 0721-832X 1435-702X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2854429354 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adrenergic alpha-1 Receptor Antagonists - adverse effects Adrenergic receptors Anterior chamber Biometrics Cataract Cataract - complications Eye surgery Humans Intraoperative Complications - diagnosis Iris Iris Diseases - chemically induced Iris Diseases - diagnosis Medicine Medicine & Public Health Ophthalmology Patients Phacoemulsification - adverse effects Prospective Studies Risk assessment Statistical analysis Sulfonamides Surgery Tamsulosin |
| title | Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome |
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