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Criteria for the Intraoperative Floppy Iris Syndrome (IFIS) Associated with Alpha-1 Antagonist Therapy (Tamsulosin, Flomax)

Description

A small percentage of patients taking the alpha-1 antagonist drug tamsulosin (Flomax) may develop an abnormality of the iris that becomes evident during ocular surgery. In theory the risk should extend to similar medications. It may be associated with surgical complications if the ophthalmologist is caught unawares; these problems can be avoided if it is anticipated and a suitable operative technique is used.


 

Tamsulosin is most commonly prescribed for men with benign prostatic hypertrophy (BPH).

 

Most cases have been reported during cataract surgery but this could occur during other types of ocular surgery as well.

 

An affected person may be currently taking tamsulosin but it can also occur in men taking the drug months or even years previously.

 

Features:

(1) The iris shows an unusual billowing ("floppiness") associated with hypotony.

(2) The pupil develops progressive miosis during surgery.

(3) The iris prolapses through an incision or other globe opening.

 

There may be variation in severity between a person's 2 eyes (one may be affected while the other not).

 


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Specialty

ICD-10