Avoiding Problems in Cataract Surgery in Eyes With Floppy Iris Syndrome

摘要

David Chang, MD, and John R. Campbell, MD, made an important discovery of an association of intraoperative complications caused by irises that seemed to be floppy during phacoemulsification in patients who were shown to be taking tamsulosin (Flomax). Ever since then, ophthalmic surgeons have been concerned about "Flomax patients" and iris-related complications during cataract surgery. Even in television commercials for the product, patients are advised to reveal to their eye surgeons if they are on the medication.However, the relationship between Flomax and floppy iris complications is in fact a statistical one. Almost all of the floppy iris cases in their series were on Flomax, but only approximately 60% of the patients who were on Flomax developed intraoperative floppy iris syndrome. Mechanical stretching of the iris to make the pupil larger seemed to make the iris even more exposed to increased floppiness.