Intraoperative Floppy Iris Syndrome: Facts for the Urologist

Intraoperative floppy iris syndrome (IFIS) consists of a triad of flaccid and billowing iris, iris prolapse through the surgical incisions, and progressive pupil constriction. IFIS increases the risk for complications during cataract surgery. It was first described in patients on tamsulosin treatment but can also be seen in patients on other non-subtype specific α1-adrenergic receptor (α1AR) antagonists. Urologists who are initiating treatment with α1AR antagonists should inform their patients that these drugs may increase the difficulty of cataract surgery, but once the ophthalmologists are forewarned, necessary safety measures can be taken to achieve good surgical results.