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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
20222826
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I am a candidate for cataract surgery and have been taking

Resolved Question:

I am a candidate for cataract surgery and have been taking Flomax for several years. I understand that one of the complications during surgery is IFLS. Could you tell me how this can be controlled during surgery and the advantages and disadvantages of the different devices/techniques.
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. James replied 6 years ago.

Dr. James :

Hello.

Dr. James :

Please Note:
JustAnswer is a public forum. Information provided is for educational purposes & does not establish a patient-physician relationship nor substitute for a personal consultation with a physician.

Do you understand those terms?

JACUSTOMER-0ttsxz49- :

Yes.

Dr. James :

Thank you.

Dr. James :

I have read your question. The discussion on this topic can get very specific and technical. Are you wanting to know what your doctor will do or what you can do to minimize complications from IFIS.

JACUSTOMER-0ttsxz49- :

I want to know what the doctor will do.

Dr. James :

Give me one moment as I type my response.

Dr. James :

Intraoperative floppy iris syndrome is a condition associated with the use of flomax and related medicines used in prostate enlargement. The medicine works to block alpha1 receptors. There is a cross reactivity of these receptors in the iris which can make them "floppy" during cataract surgery.

The effect of the medicine is cumulative and does not go away even if the medicine is stop. Some doctors may ask you to stop the medicine before surgery while others will have you continue it. Either way, there is a risk of floppy iris during the surgery.

Dr. James :

The most important part of IFIS management is to be aware that a patient is on Flomax. In many surgeries on patients with Flomax, there are not problems. Things your doctor may do is to utilize epinephrine injected into the eye right before the cataract removal. He may also take care to make his corneal wound not too posterior so ask to keep the iris from clogging up the wound during the surgery.

It is important to construct a good wound to minimize that amount of leakage out of the would during the surgery.

Dr. James :

If the dilation of the iris is poor, your doctor may choose to use iris hooks.

Dr. James :

You doctor may also lower the fluid flow rate of the phaco macine.

Dr. James :

*machine.

JACUSTOMER-0ttsxz49- :

Tell me about the use of iris hooks compared with the malyugen ring and which is better at holding the iris in place.

Dr. James :

They are roughly equivalent. The malyugen ring expands the iris in a circumfirential fashion and mimics the natural dilation of the eye. The iris hooks are inserted through 4 small puncture wounds of the eye and pulls the iris open in a square shape.

Dr. James :

The ring is newer and more natural in its expansion but more expensive as well. It may not be available in every facility.

Dr. James :

If used in experienced hands, both works well.

Dr. James :

Does that answer your question?

Dr. James :

Hello?

Dr. James :

Are you still there?

JACUSTOMER-0ttsxz49- :

yes.

Dr. James :

I thought I lost you. I happy to clarify or answer other questions if you have them.

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