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Comparative analysis, management, and surgical outcome of intraoperative floppy iris syndrome (IFIS) associated with tamsulosin, alfuzosin, and silodosin

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Session Details

Session Title: Cataract Surgery & Glaucoma

Session Date/Time: Sunday 23/09/2018 | 14:00-16:00

Paper Time: 15:38

Venue: Room A3, Podium 1

First Author: : M.Mahendra INDIA

Co Author(s): :    S. Mahendra                    

Abstract Details


To compare the incidence of intraoperative floppy iris syndrome (IFIS) in men taking Tamsulosin,Alfuzosin and Silodosin and assess the surgical outcome following its management.


Khairabad Eye Hospital,Kanpur,India


We performed cataract surgeries in 112 eyes of 94 patients who were using alpha1-adrenergic receptor antagonists for their benign prostatic hypertrophy (BPH) treatment.The patients were divided into three groups.Group A,B and C which included patients using Tamsulosin,Alfuzosin and Silodosin respectively.A detailed ocular examination was done.Standard pre-operative regime used was topical nepafenac (0.1% w/v) two hours prior to surgery followed by pupillary dilatation by topical tropicamide (0.8% w/v) and phenylephrine (5%w/v).Routine phacoemulsification was performed with Alcon infinity phaco machine using ozil technology and direct phacochop technique through a 2.2mm clear corneal temporal incision.Presence or absence of IFIS was observed.


Out of the 69 cases taking Tamsulosin 29 (42%) developed IFIS,27 cases taking Alfuzosin 5 (18.5%) developed IFIS and 16 cases taking Silodosin 1 developed IFIS.Intraoperative complications were minimal with few incidents of Iris chafing, focal iris stromal atrophy,iris trauma,iris incarceration of the wound,and cystoid macular oedema.There was no case of posterior capsular rupture or vitreous loss.Higher risk of complications were observed in eyes with patients using Tamsulosin.


Tamsulosin users were found to have a significant higher risk for developing IFIS as compared to Alfuzosin and Silodosin.Pre-cautionary measures included gentle hydrodissection,intracameral use of epinephrine,lowered phaco parameters,use of appropriate ocular viscoelastic devices (OVD) and malyugin ring in cases of intraoperative miosis.Silodosin was found to be the most safest drug.

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