Indian Journal of Ophthalmology

ORIGINAL ARTICLE
Year
: 2014  |  Volume : 62  |  Issue : 8  |  Page : 870--875

Intraoperative floppy iris syndrome in Indian population: A prospective study on incidence, risk factors, and impact on operative performance


Shilpa Goyal1, Deepansh Dalela2, Neeraj Kumar Goyal2, Shobhit Chawla3, Rajat Dhesi3, Bela Kamboj3, Abha Dalela3 
1 Department of Ophthalmology, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Urology, King George Medical University, Lucknow, Uttar Pradesh, India
3 Eye-Q Super Specialty Eye Hospitals, Prakash Netra Kendra, Lucknow, Uttar Pradesh, India

Correspondence Address:
Neeraj Kumar Goyal
Room No. 204, Resident Hostel, King George�SQ�s Medical University, Lucknow, Uttar Pradesh - 226 003
India

Purpose: The purpose of this study was to evaluate the incidence, risk factors, and impact of intraoperative floppy iris syndrome (IFIS) on surgical performance. Materials and Methods : Consecutive cataract surgeries from October 2010 to Feb 2011 (1003 eyes, 980 patients; 568 males, 412 females) were analyzed prospectively. Operating surgeon, masked about medication history, noted the intraoperative details. Cases were identified as IFIS or non-IFIS. Multivariate analysis was performed to find risk factors for IFIS. Results : Prevalence of tamsulosin use among men undergoing cataract surgery was 7.0% (41) with incidence of IFIS 4.78% (48). On multivariate analysis, hypertension (OR: 3.2, 95% confidence interval, 95% CI: 1.39-6.57; P = 0.005), use of tamsulosin (OR: 133.32, 95% CI: 50.43-352.48; P < 0.0001), or alfuzosin (OR: 9.36, 95% CI: 2.34-37.50; P = 0.002) were the factors associated with IFIS. Among men taking tamsulosin (n = 41) and alfuzosin (n = 28), 68.3% and 16.6% developed IFIS, respectively. In subgroup analysis of men on tamsulosin, no factor added to the risk posed by tamsulosin. Seventeen of 944 eyes not exposed to any drug had IFIS (0.018%). On subgroup analysis, only risk factor for IFIS was hypertension (OR: 4.67, 95% CI: 1.63-13.35; P = 0.002). Of 48 IFIS eyes, the surgeon observed increased difficulty in 57.1% (21) and additional measures were required in 9 eyes. Mean operative time was increased in IFIS eyes (11.68 ± 3.46 vs. 10.01 ± 0.22 min; P = 0.001). Surgical outcome was good in all cases. Conclusion : The prevalence of tamsulosin intake and IFIS incidence is higher in India. Current tamsulosin/alfuzosin use and hypertension are important risk factors. IFIS makes the surgery more difficult, significantly prolongs the operative time, and predisposes for other intraoperative complications. However, with appropriate management, final operative outcome is not affected.


How to cite this article:
Goyal S, Dalela D, Goyal NK, Chawla S, Dhesi R, Kamboj B, Dalela A. Intraoperative floppy iris syndrome in Indian population: A prospective study on incidence, risk factors, and impact on operative performance .Indian J Ophthalmol 2014;62:870-875


How to cite this URL:
Goyal S, Dalela D, Goyal NK, Chawla S, Dhesi R, Kamboj B, Dalela A. Intraoperative floppy iris syndrome in Indian population: A prospective study on incidence, risk factors, and impact on operative performance . Indian J Ophthalmol [serial online] 2014 [cited 2024 Mar 29 ];62:870-875
Available from: https://journals.lww.com/ijo/pages/default.aspx/article.asp?issn=0301-4738;year=2014;volume=62;issue=8;spage=870;epage=875;aulast=Goyal;type=0