Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome.

Paschon, Karin; Szegedi, Stephan; Weingessel, Birgit; Fondi, Klemens; Huf, Wolfgang; Vécsei-Marlovits, Pia Veronika (2024). Prospective analysis of anatomic features predisposing patients to intraoperative floppy iris syndrome. Graefe's archive for clinical and experimental ophthalmology, 262(1), pp. 103-111. Springer 10.1007/s00417-023-06165-3

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PURPOSE

To aid preoperative risk assessment by identifying anatomic parameters corresponding with a higher risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery.

METHODS

Prospective cohort study of 55 patients with α1-adrenergic receptor antagonist (α1-ARA) treatment and 55 controls undergoing cataract surgery. Anterior segment optical coherence tomography (AS-OCT), video pupilometer, and biometry measurements were performed preoperatively and analyzed regarding anatomic parameters that corresponded with a higher rate of IFIS. Those statistically significant parameters were evaluated with logistic regression analysis and receiver operating characteristic (ROC) curve.

RESULTS

Pupil diameter was significantly smaller in patients who developed IFIS compared to those who did not develop IFIS (AS-OCT 3.29 ± 0.85 vs. 3.63 ± 0.68, p = 0.03; Pupilometer 3.56 ± 0,87 vs. 3.95 ± 0.67, p = 0.02). Biometric evaluation revealed shallower anterior chambers in the IFIS group (ACD 3.12 ± 0.40 vs. 3.32 ± 0.42, p = 0.02). Cutoff values for 50% IFIS probability (p = 0.5) were PD = 3.18 mm for pupil diameter and ACD = 2.93 mm for anterior chamber depth. ROC curves of combined parameters were calculated for α1-ARA medication with pupil diameter and anterior chamber depth, which yielded an AUC of 0.75 for all IFIS grades.

CONCLUSION

The combination of biometric parameters with history of α1-ARA medication can improve assessment of risk stratification for IFIS incidence during cataract surgery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ophthalmology

UniBE Contributor:

Paschon, Karin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1435-702X

Publisher:

Springer

Language:

English

Submitter:

Pubmed Import

Date Deposited:

11 Jul 2023 08:44

Last Modified:

24 Jan 2024 00:12

Publisher DOI:

10.1007/s00417-023-06165-3

PubMed ID:

37428221

Uncontrolled Keywords:

Biometry Cataract surgery IFIS Intraoperative complication Intraoperative floppy iris syndrome Patient safety

BORIS DOI:

10.48350/184668

URI:

https://boris.unibe.ch/id/eprint/184668

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