Risk factors for intraoperative floppy iris syndrome: One year prospective study

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Intraoperative Floppy Iris Syndrome (IFIS) was associated with a-blockers use. Our purpose was to evaluate risk factors for IFIS in patients undergoing phacoemulsification.


Participants in our study were 1024 patients, who underwent routine phacoemulsification cataract surgery. The following data were recorded and evaluated as possible risk factors for IFIS: ophthalmological conditions (glaucoma, pseudoexfoliation, age-related macular degeneration), sociodemographic features, axial length, hypertension, diabetes mellitus and medications being taken at the time of surgery. Cases were characterized intraoperatively as IFIS and non-IFIS. Univariate and multivariate logistic regression was performed with SPSS 19.0.


IFIS was observed in 61/1024 eyes (5.9%, 95%CI: 4.3%-7.2%). Current use of tamsulosin, alfuzosin, terazosin, benzodiazepines, quetiapine and finasteride were all independently associated with IFIS. Borderline associations were noted for rivastigmine. Hypertension and short axial length were also significantly associated with IFIS. It is worthy to note that IFIS was not associated with the duration of a-blockers intake.


Apart from the well-established associations with alpha1-adrenergic receptor antagonists, this prospective study points to benzodiazepines, quetiapine, hypertension and short axial length as potential risk factors for IFIS.

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