Observation Of Intraoperative Floppy-iris Syndrome In Phacoemulsification Cataract Surgery In A Chinese University Hospital

Purpose:To observe Chinese incidence of intraoperative floppy iris syndrome (IFIS) during phacoemulsification cataract surgery and the following complications and outcomes. Explore new risk factors of IFIS. Discuss whether dilated pupil diameter (PD) could be regarded as a predict factor of IFIS.Design:Prospective, observational case series.Method:We performed a single-center study including807Han Chinese people (1068eyes) undergoing cataract surgery. The medicine administration, PD before and after mydriasis, signs and managements of IFIS were recorded. Follow-up of one week was performed to observe outcomes of surgery.Results:34of1068eyes (3.18%) showed the signs of IFIS. According to regression, following parameters were considered risk factors of IFIS:finasteride (OR=5.9,95%confidence interval (CI),1.6-21.3), tamsulosin (OR=21.6, CI,4.0-115.7), reserpine (OR=12.9, CI,2.6-64.2), clozapine (OR=129.5, CI,11.1-1.5E3) and post-panretinal phacocoagulation (OR=10.8, CI,1.2-95.2). Micro-incision and small incision cataract surgeries had similar IFIS incidence (p=0.318). Patients having smaller post-dilated PD were prone to occur IFIS (p<0.001), especially for those whose PD less than7.25mm. Patients without IFIS had fewer complications and received slightly better outcomes than those with IFIS in a week after the surgery.Conclusions:Incident rate of IFIS in a Chinese hospital was3.18%. We discovered three new risk factors of IFIS:reserpine, clozapine and post-panretinal photocoagulation. Mydriasis difficulty may imply the IFIS occurrence. Size of incision is not related to IFIS incidence. Proper managements can control IFIS development effectively and assure the prognosis relatively.