Article Text

Possible mechanism of intraoperative floppy iris syndrome: a clinicopathological study
  1. T Goseki1,
  2. K Shimizu1,
  3. H Ishikawa2,
  4. H Nishimoto1,
  5. S Uga3,
  6. N Nemoto4,
  7. P N Patil5
  1. 1
    Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
  2. 2
    Department of Orthoptics and Visual Science, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
  3. 3
    Department of Ophthalmology, International University of Health and Welfare, Tochigi, Japan
  4. 4
    Research Center for Biological Imaging, Kitasato University School of Medicine, Kanagawa, Japan
  5. 5
    Division of Pharmacology, College of Phamacy, The Ohio State University, OH, USA
  1. Dr T Goseki, 1-15-1, Kitasato, Sagamihara, Kanagawa 228-8555, Japan; gosekikun{at}

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Recently “intraoperative floppy iris syndrome (IFIS)” was observed during cataract surgery. The fluttering of the iris during phacoemulsification occurs,1 but its mechanism is unknown. The present study examines three eyes of two patients with conditions similar to IFIS after chronic topical use of bunazosin (Detantol, Santen, Osaka, Japan) an α1-adrenoceptor blocker. The medication is used in Japan for the treatment of glaucoma. A histological study was conducted to provide the explanation for the syndrome.

Case reports

Both patients, a 77-year-old woman and a 79-year-old man, who had used bunazosin eye-drops for 3 years, had unremarkable medical histories, with no trauma. Slit-lamp biomicroscopy revealed no abnormalities other than glaucoma and cataract. Both patients underwent cataract surgery, during which IFIS was observed, but no other complications were seen in either. In each eye, we performed peripheral iridectomy (about 1 mm) and, after immediately …

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