What is Intraoperative Floppy Iris Syndrome?

Intraoperative floppy iris syndrome is a condition that may occur during ophthalmological surgery. IFIS is defined by certain criteria, including iris shrinkage and iris prolapse at the surgical site. As the name would suggest, floppy iris syndrome symptoms also include an iris that appears floppy or billowing.


Intraoperative Floppy Iris Syndrome Causes

The occurrence of intraoperative floppy iris syndrome has been linked to patients taking tamsulosin. Also sold under the brand name, Flomax, tamsulosin is a urinary retention medication used to treat benign prostatic hyperplasia (BPH) in men. Women may also be prescribed tamsulosin for urinary issues. In addition to its intended purpose, tamsulosin may also impact the receptors that control the iris’s sphincter muscle contractions.

Understand the surgical errors present in your IFIS case


Intraoperative Floppy Iris Syndrome Treatment

When ophthalmological surgeons encounter IFIS during a cataracts surgery, they have a few best practices for treatment. These include expansion rings and iris hooks/retractors. If used correctly, iris hooks offer a mechanical method for reversing miosis. Further, hooks and retractors can help prevent iris prolapse during surgery.

Floppy Iris Syndrome Post-Operative Care

Clinicians also have options to treat iris prolapse post-surgery. Most important for prolapse reversal is a watertight seal on the wound. Another crucial step is administering Miochol, a chemical solution that causes the pupil to contract.


Surgical Complications & Floppy Iris Syndrome

Surgeons must remain vigilant for signs of IFIS over the course of cataracts surgery. However, the tools and methods for treatment also present operational risks. Iris hooks and retractors can be effective interventions for IFIS. But they can also cause serious iris trauma (excessive stretching or manipulation) if implemented incorrectly.

Ophthalmological surgery presents a steep learning curve to clinicians. Attorneys pursuing IFIS cases should investigate operator error and training level when considering a surgical mismanagement approach.