Predictive value of pupillography on intraoperative floppy iris syndrome in preoperative period

Effects of Alpha-Lytic Therapy Withdrawal on Choroidal Parameters in Intraoperative Floppy Iris Syndrome High-Risk Patients

Background/Objectives: The aim of this study is to investigate the effect on choroidal parameters of drug withdrawal in patients taking α1 adrenergic receptor antagonist (ARA) inhibitors. Methods: In total, 32 eyes of 32 patients under alpha-lytic therapy, and 32 eyes of 32 control subjects, both scheduled for cataract surgery in the fellow eye, were included. EDI-OCT was performed in all patients and subfoveal choroidal thickness (SFCT), luminal choroidal area (LCA), stromal choroidal area (SCA), total choroidal area (TCA), and choroidal vascularity index (CVI) during the preoperative visit were compared with data approximately 1 month after alpha-lytic withdrawal. The same assessments were performed in the control group. Results: SFCT and LCA were significantly reduced in the patients 1 month after alfa-lytic therapy withdrawal (p < 0.05), whereas in the control group, no changes in choroidal parameters were observed. Conclusions: The data proved that α1ARA inhibitors affected choroidal vessels, whereas no modification of choroidal stroma was observed.

Dealing with floppy iris syndrome

PURPOSE OF REVIEW

The aim of this study was to review and summarize recent findings and advancements regarding intraoperative floppy iris syndrome (IFIS). Although many improvements have been made for the management of IFIS, it remains a challenging condition for surgeons. An understanding of the syndrome as well as the multitude of tools to mitigate risk of complication is important for surgeons operating on high-risk patients.

RECENT FINDINGS

A variety of management approaches have been modified and improved or further supported with new data, such as intracameral compounds, intraoperative devices and surgical techniques.

SUMMARY

An understanding of risk factors is important for the identification of at-risk patients. A variety of approaches can greatly reduce incidence of IFIS complications. Multiple management strategies should be utilized to further reduce risk during these difficult surgeries.