Alpha antagonists linked to increased risk of intraoperative floppy iris syndrome
The risk of intraoperative floppy iris syndrome, or IFIS, was markedly increased in patients who used selective or nonselective alpha-antagonists before cataract surgery, according to study findings.
Data were culled from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project conducted by the Veterans Health Administration. The retrospective study included 1,254 patients who used alpha antagonists before cataract surgery; 587 patients used selective alpha antagonists, 627 patients used nonselective alpha antagonists and 40 patients used both.
In total, 569 patients had IFIS, among whom 428 patients had taken alpha antagonists preoperatively (P < .00001). Pupillary expansion devices were used during surgery in 430 cases. Of those patients, 186 patients had IFIS; the prevalence of IFIS in this subgroup was also considered significant (P < .0001). Ninety-five of the 186 patients had taken selective alpha antagonists, 38 had taken nonselective alpha antagonists, three patients used both and 50 used neither.
Patients with IFIS had significantly increased odds of intraoperative complications, with 86 patients having at least one complication, and 39 patients reporting more than one complication, according to the researchers (P < .001).
Disclosure: Vollman is a consultant for ForSight5 and Bayer Pharmaceuticals.