What Ophthalmologists Need To Know About Treating Floppy Iris Syndrome

What Ophthalmologists Need To Know About Treating Floppy Iris Syndrome

Ophthalmologists at surgical centers are always looking for new, on-site procedures that can expand the horizons of their business.

And university programs that train the next generation of ophthalmologists are always interested in finding new skills with which they can equip their students.

Acquiring the knowledge base and the tools to successfully treat floppy iris syndrome is one way in which both of these goals can be accomplished.


What Is Floppy Iris Syndrome?

Intra-operative floppy iris syndrome (IFIS) is a condition that sometimes occurs during a cataract extraction. It is a complication characterized by a limp, loosely hanging iris that billows up in reaction to the normal circulation of intra-ocular fluids as they pass from the posterior to the anterior chambers of the eye.

There is also a tendency of this "floppy" iris to "prolapse" (fall forward) toward the part of the eye from which the cataract was extracted. Finally, floppy iris syndrome also can lead to progressively worsening constriction of the pupil.

What Causes This Condition?

Floppy iris syndrome commonly occurs in association with a number of medications, which are thought by many to actually cause the condition, and Flomax is first and foremost among these.

Flomax is used to treat prostatic hyperplasia. It works by relaxing the bladder muscles, but as a side effect, it also causes the iris-dilation muscle to relax. Unfortunately, even a single dose can lead to a floppy iris condition during cataract removal.

Other medications thought to cause a floppy iris include finasteride, which also may contribute to the development of cataracts, and various prescription pharmaceuticals used to treat diabetes, hypertension, and glaucoma. Many times, those things that cause a small pupil condition will also cause a floppy iris.

It should be noted that this syndrome is a relatively rare complication during cataract removal. It should also be kept in mind that the condition does not necessarily negate the effectiveness of a cataract extraction, though it can lead to increased post-operative pain and a lengthened recovery time.

Diagnosing The Condition

Floppy iris syndrome, due to its rarity and uniqueness, is not very well understood by most ophthalmologists at present.

It often causes alarm and confusion, therefore, when it is encountered by those performing cataract surgeries. Thus those who learn to diagnose and treat this condition will be a step ahead of much their competition and in a position to better serve their patients.

The combination of the following three clinical signs, with or without a poorly dilated pre-surgery pupil, are diagnostic of floppy iris syndrome:

  1. A pupil that progressively constricts during cataract surgery
  2. An iris with a limp appearance and that billows in response to even normal fluid circulation
  3. An iris that tends to prolapse towards the incisions made in the eye to remove the cataract, both during and following the extraction

Prevention And Treatment

Both prevention during cataract surgery and subsequent treatment involve the same methods, including mechanical tools and chemical agents.

Agents include atropine, which is injected at intervals before the surgery; phenylephrine, injected below the iris during surgery; and viscoelastic agents, used to lessen phaco-aspiration and vacuum settings.

However, in severe cases, iris hooks, retractors, and expanders are most effective. They serve to restrain the iris so that it will not prolapse during the surgery and to maintain a sufficient pupil size.

In fact, many studies conducted on treating the condition have concluded that the only way to deal with extreme cases is to somehow retract the iris and/or expand the pupil, and mechanical tools are by far the most reliable method.

Ordering Instruments To Treat Floppy Iris Syndrome

Those charged with ordering and re-ordering ophthalmic instruments needed to conduct various eye surgeries, including floppy iris syndrome, need a supplier that gives them the highest quality, a competitive price, and fast, no hassle delivery.

Accutome supplies some of tools needed to treat a floppy iris that meets the above criteria.


Floppy iris syndrome is a complication of cataract removal surgery that is relatively rare and little understood.

Those ophthalmology practices that endeavor to learn how to diagnose, prevent, and treat this conditions will offer services that many of their competitors lack and give their patients a superior experience.

Iris hooks, retractors, expansion rings, and other tools needed to prevent or treat a floppy iris can be conveniently ordered from online suppliers such as Accutome.

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