How is IFIS treated?

If you are having intraocular surgery, it is very important that you tell your ophthalmologist (Eye M.D.) if you are taking any medications for BPH. Studies have shown that as long as the surgeon is aware that patients are taking alpha-blockers or have taken them in the past, the success rate with cataract surgery is still excellent. Your surgeon may use additional dilating agents or a device to stabilize your iris to minimize the risk of complications.

Be sure to talk with your ophthalmologist before eye surgery if you take any BPH medications.

Alan J. Margolis, MD

IFIS stands for intraoperative floppy iris syndrome.  Over the past several years, ophthalmologists have taken note that patients with a history of alpha blocker use may be subject to the IFIS syndrome.  Alpha blockers have been used in men for benign prostatic hypertrophy, and in women for urinary incontinence.  It is very important for your ophthalmologist to know whether you have any history of taking such medications.  Taking an alpha blocker at any time in the past for any length of time alerts us to the possibility of this condition and allows us to take steps to avoid the complications associated with the IFIS syndrome.  Specifically, during cataract surgery, IFIS presents as a floppy iris which often does not dilate to a "normal" extent.  There is an increased rate of complications during cataract surgery in patients with this condition.  Ophthalmologists have a range of options available for addressing this condition.  Many of us feel that prevention and anticipation of this condition gives us the best chance to avoid complications in surgery.  For this reason, I often use atropine drops preoperatively, as well as instilling preservative-free epinephrine during cataract surgery.  There are several agents which help stabilize the iris within the eye, as well as hooks and rings which can be used to expand the iris once surgery has been started.  The key to success in these situations is the awareness by your ophthalmologist of a history of these medications in your past and the anticipation of difficulties so that they can be avoided whenever possible.  That said, the success rate of cataract surgery in patients with a history of alpha blocker use remains excellent and has improved since our awareness of this syndrome has become widespread.

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