title: Intraoperative floppy-iris syndrome: comparison of tamsulosin and drugs other than alpha antagonists.
abstract: BACKGROUND
  To determine and compare the incidence of intraoperative floppy iris syndrome (IFIS) features in patients using tamsulosin, and other chronic medications.
  
  
  METHODS
  We prospectively studied patients who underwent phacoemulsification (PE) between March 2006 and October 2007 on use of tamsulosin or a single medication like antihypertansive (AH), antiaggregant (AAg), antipsycotic (AP) or oral antidiabetic (OAD). Patients were grouped as tamsulosin users (Group 1), previous tamsulosin users (Group 2), chronic medication users (AH, AAg, AP or OAD) (Group 3) and patients with no medication (Group 4). Comparison of pre and postoperative visual acuities, intraocular pressures, intraoperative posterior capsular rupture (PCR) rates and grades of IFIS among groups were evaluated.
  
  
  RESULTS
  We studied 1567 eyes of 1530 subjects. Twenty five eyes in the study demonstrated IFIS (1.6%). Five cases were included in Group 1 and IFIS incidence was 80%, while it was 60% in Group 2 (n = 5), 1 % in Group 3 (n = 1099), 1.7% in Group 4 (n = 421). IFIS incidence was significantly higher in Groups 1 and 2 compared to Groups 3 and 4 (p < 0.001). There was no difference between Groups 1 and 2 (p = 1.0) and between 3 and 4 (p = 0.29). Most cases (72%) had all three signs of IFIS. Complete IFIS was seen in one patient in Groups 1 and 2, whereas it was seen in all IFIS patients of Groups 3 and 4 (p < 0.001). Incidence of PCR was significantly higher in Group 1 (p = 0.045).
  
  
  CONCLUSIONS
  Tamsulosin was found to be the drug which was most likely to be associated with IFIS, but IFIS was also observed in patients chronically using losartan, aspirin, chlorpromazine and metformin. Although, IFIS incidences were found to be similar between chronic users of these drugs and those using no medications at the time of surgery, new studies in the future will introduce the predisposing factors and the possible mechanisms of IFIS with these medications.
authors: Department of Ophthalmology, Ministry of Health, Ankara Training and Research Hospital, Cebeci, Ankara, Turkey. drpinar@yahoo.com
authors: Pinar
authors: P
authors: Altiaylik Ozer
authors: Ugur Emrah
authors: UE
authors: Altiparmak
authors: Nurten
authors: N
authors: Unlu
authors: Dicle Oncel
authors: DO
authors: Hazirolan
authors: Remzi
authors: R
authors: Kasim
authors: Sunay
authors: S
authors: Duman
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D007431:Intraoperative Complications / Q000188:drug therapy*; D007499:Iris Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects*; D011446:Prospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D000077409:Tamsulosin; D016896:Treatment Outcome
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000959:Antihypertensive Agents; D014150:Antipsychotic Agents; D007004:Hypoglycemic Agents; D013449:Sulfonamides; D000077409:Tamsulosin