title: Preoperative use of atropine to prevent intraoperative floppy-iris syndrome in patients taking tamsulosin.
abstract: Intraoperative floppy-iris syndrome (IFIS) is a recently identified condition associated with phacoemulsification in patients using the alpha1-antagonist tamsulosin (Flomax). Patients with IFIS manifest a triad of symptoms during cataract surgery: fluttering and billowing of iris stroma due to normal fluid movement, propensity of iris prolapse to phaco and side-port incisions, and progressive constriction of the pupil. Prevention of IFIS by withdrawing tamsulosin preoperatively has not shown consistent benefit. We describe the preoperative administration of atropine, which effectively prevented the occurrence of IFIS in patients receiving tamsulosin.
authors.affiliation: Mayo Clinic Jacksonville, Jacksonville, FL 32224, USA. bendel.rick@mayo.edu
authors.forename: Rick E
authors.initials: RE
authors.lastname: Bendel
authors.forename: Michael B
authors.initials: MB
authors.lastname: Phillips
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects; D001285:Atropine / Q000008:administration & dosage*; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D007498:Iris / Q000187:drug effects*; D007499:Iris Diseases / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D018918:Phacoemulsification; D011300:Preoperative Care; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D013449:Sulfonamides / Q000009:adverse effects*; D013577:Syndrome; D000077409:Tamsulosin
chemical_list: D000317:Adrenergic alpha-Antagonists; D009184:Mydriatics; D009883:Ophthalmic Solutions; D013449:Sulfonamides; D001285:Atropine; D000077409:Tamsulosin