Factors Predisposing To Intraoperative Floppy-Iris Syndrome: An Up-To-Date Meta-Analysis

    July 2022 in “ Journal of Cataract and Refractive Surgery ”
    Chrysanthos D. Christou, Stepan M. Esagian, Nikolaos Ziakas, Efthymia Prousali, Argyrios Tzamalis
    TLDR Certain medications and conditions increase the risk of intraoperative floppy-iris syndrome.
    This meta-analysis reviewed 38 studies to identify factors predisposing to intraoperative floppy-iris syndrome (IFIS), a condition that increases intraoperative complications. Significant risk factors include male sex (OR 4.25), hypertension (OR 1.55), tamsulosin (OR 31.06), finasteride (OR 4.60), benzodiazepines (OR 2.88), and antipsychotics (OR 6.91). A decreased preoperative dilated pupil also predisposes to IFIS. Intracameral epinephrine was investigated as a prophylactic measure but did not show statistical significance. Comprehensive preoperative risk assessment is crucial to mitigate the risk of IFIS and prevent significant visual morbidity during surgery.
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