title: Intraoperative floppy-iris syndrome associated with use of antipsychotic drugs.
abstract: OBJECTIVE
  We report 3 cases of intraoperative floppy-iris syndrome (IFIS) during cataract surgery in patients without a history of selective α1-blocker use but with a long-term history of antipsychotic drug use. We reviewed previously reported cases of antipsychotic drug-associated IFIS cases.
  
  
  METHODS
  Observational case series.
  
  
  RESULTS
  In case 1, bilateral IFIS developed in a 39-year-old man with chronic angle-closure glaucoma. He had used several classes of antipsychotic drugs to treat schizophrenia, including the first-generation antipsychotic drugs haloperidol and chlorpromazine, the dopamine system stabilizer aripiprazole, the dopamine serotonin antagonists olanzapine and quetiapine, and the serotonin dopamine antagonists risperidone and blonanserin for 7 years. In case 2, a 63-year-old woman with schizophrenia had used aripiprazole, quetiapine, and risperidone for more than 10 years. In case 3, a 65-year-old woman with an organic mental disorder had used haloperidol for more than 10 years. At least 5 cases of antipsychotic drug-induced IFIS have been reported in the literature.
  
  
  CONCLUSIONS
  Any class of antipsychotic drugs can cause IFIS. Although antipsychotic drug-induced IFIS can be mild, surgeons should be alert to the possibility of IFIS when they treat patients with current and past use of antipsychotic drugs.
authors: Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
authors: Masato
authors: M
authors: Matsuo
authors: Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
authors: Ichiya
authors: I
authors: Sano
authors: Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
authors: Yoshifumi
authors: Y
authors: Ikeda
authors: Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan.
authors: Etsuko
authors: E
authors: Fujihara
authors: Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Japan. Electronic address: tanito-oph@umin.ac.jp.
authors: Masaki
authors: M
authors: Tanito
mesh_terms: D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects*; D002387:Cataract Extraction; D005260:Female; D015812:Glaucoma, Angle-Closure / Q000601:surgery; D005902:Glaucoma, Open-Angle / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D007499:Iris Diseases / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*; D014130:Trabeculectomy; D014792:Visual Acuity / Q000502:physiology
chemical_list: D014150:Antipsychotic Agents