Clinical factors associated with floppy iris signs: a prospective study from two centers.

BACKGROUND AND OBJECTIVE

To evaluate the relationship of intraoperative floppy iris syndrome with pseudoexfoliation, diabetes mellitus, hypertension, and alpha-1 adrenergic blocker (A1AB) use.

PATIENTS AND METHODS

Five hundred patients were included in this prospective study. Intraoperative adverse events, such as pupillary constriction, iris billowing, and iris prolapse from the wound, were noted. Multinomial regression analysis was used to evaluate the relationship of intraoperative floppy iris syndrome with pseudoexfoliation, diabetes mellitus, hypertension, pupil diameter, and A1AB use.

RESULTS

Pupil constriction was significantly associated with pseudoexfoliation (P < .001). Diabetes mellitus was associated with pupil constriction and iris billowing (P = .005 and .003, respectively). Hypertension was associated with pupil constriction (P = .021). Intraoperative floppy iris syndrome was strongly associated with A1AB use and male gender (P < .001 and .039, respectively).

CONCLUSION

Intraoperative floppy iris syndrome was observed in 2.8% of patients and was strongly related to A1AB use, particularly in smaller pupil diameters. Pseudoexfoliation, diabetes mellitus, and hypertension were not associated with intraoperative floppy iris syndrome.