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Abstract
Intra-operative floppy iris syndrome is a newly
recognized syndrome characterized by a triad of signs:
1. A floppy iris that billows in response to normal irrigation
currents in the anterior chamber.
2. A marked propensity for the iris to prolapse to the phaco
and sideport incisions.
3. Progressive pupillary constriction during surgery.
Two additional characteristics often accompany the
IFIS-poor preoperative pupil dilation and elasticity of the pupil
margin.
All these elements make cataract surgery more difficult
and increase the risk for complications.
The occurrence of intra-operative floppy iris syndrome
has been connected with the use of tamsulosin in several case
reports and observational studies.
Tamsulosin is an antagonist of alpha1A adrenoceptors
and is one of the most commonly prescribed agents to improve
urinary outflow in men with benign prostatic hypertrophy.Alpha-1 adrenergic receptor blockers such as tamsulosin
competitively inhibit the sympathetic autonomic nervous
system, resulting in relaxation of the smooth muscles in
peripheral blood vessels and in the bladder neck and prostatic
urethra.
Tamsulosin has 24-fold greater affinity for α-1A than α-
1B receptors.