Floppy Iris Syndrome: What You Should Know

Floppy Iris Syndrome: What You Should Know

Intraoperative Floppy Iris Syndrome, or IFIS, was first diagnosed as a strange interplay between two common effects of aging: the development of cataracts and prostate enlargement among men. Any man who suffers from both ailments, and any person who has taken alpha blockers, a class of drugs commonly prescribed for common side effects of aging, should be aware of IFIS and take some simple steps to guard against potentially harmful effects during cataract surgery.

Alpha Blockers And Their Effect On Your Iris

Doctors routinely prescribe drugs referred to as alpha blockers, such as Flomax, Uroxatral, Minipress, and Cardura, for the frequent urination that accompanies an enlarged prostate. According to the Mayo Clinic, alpha blockers are also prescribed for high blood pressure, kidney stones, and urinary symptoms in women.

According to the chair of the American Association of Ophthalmology (AAO), David Chang, M.D., one of the stranger side effects of alpha blockers is an iris that becomes flaccid within the fluid in the eye; during cataract surgery, the iris may not remain dilated, which leads to a contracted pupil. Replacing a lens during cataract surgery can be complicated when the pupil is small or contracted; surgery can be even more difficult if a surgeon is not aware that this could occur.

Some studies have found that even after a patient has discontinued alpha blockers, he or she could still have IFIS. In 2008 the AAO and the American Society of Cataract and Refractive Surgery (ASCRS) recommended that doctors who are considering prescribing alpha blockers to their patients first have those patients consult an ophthalmologist; he can assess the likelihood that the patient will need cataract surgery in the near future, and together, the doctors can determine what is in the patient’s best interest.

When Should You Tell Your Doctor?

Cataract surgery can be successful for a person with IFIS. However, if you have ever used alpha blockers in the past, you should inform your cataract surgeon at your initial consultation so that she can prepare to minimize the risks associated with IFIS, which include retinal detachment or severe iris defects. This simple step will lead to a prepared surgeon, and a better chance for a successful surgery and a smooth recovery. After surgery, contact your doctor immediately if you experience any concerning symptoms. Be sure to consult your doctor about what to expect after surgery in your situation.

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