Bilateral Intraoperative Floppy Iris Syndrome Associated with Silodosin Intake

Abstract

ntraoperative floppy iris syndrome (IFIS) is described by three characteristics: floppy iris that billows inreaction to intraocular fluid currents during phacoemulsification surgery, flaccid iris stroma that tends toprolapse through well-constructed surgical incisions, and progressive pupillary miosis despite preoperativepharmacologic dilatation. A 63-year-old man presented with decreased vision in both his eyes. Ophthalmicexamination revealed bilateral nuclear cataract. He was prescribed silodosin for the management of benignprostatic hyperplasia a month ago. Consecutive cataract surgery was planned at a 2-week time interval. Allfeatures of IFIS were encountered in both eyes of the patient during phacoemulsification surgery. IFIS wassuccessfully managed by the aid of an iris retractor, and a 20/20 final visual acuity was achieved postoperatively in both eyes of the patient. To the best of our knowledge, this is the first study about bilateral IFISassociated with silodosin intake. Ophthalmologists and urologists prescribing silodosin should be aware ofthis possible association.