{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T21:54:35Z","timestamp":1773093275716,"version":"3.50.1"},"reference-count":14,"publisher":"American Society of Consultant Pharmacists","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:p><jats:bold>Objective<\/jats:bold> To evaluate the literature related to the use of alpha1-blockers and the risk of intraoperative floppy iris syndrome (IFIS), particularly in cataract surgery. IFIS is characterized by floppiness or billowing of the iris, iris prolapse, and progressive miosis, possibly\n leading to severe complications. It is thought to be associated with adrenergic alpha-1 receptor antagonists commonly used to treat lower urinary tract symptoms in patients with benign prostatic hyperplasia.  <jats:bold>Data Sources<\/jats:bold> A literature search was conducted in Pubmed, EMBASE,\n and Web of Science through May 2021 with MeSH terms and keywords 'intraoperative floppy iris syndrome,\u2019 ' adrenergic alpha-1 receptor antagonists,' and 'cataract surgery.'  <jats:bold>Study Selection and Data Extraction<\/jats:bold> Relevant articles were reviewed and included. In addition,\n reference lists from identified publications were reviewed to identify additional reports and studies of interest.  <jats:bold>Data Synthesis<\/jats:bold> Numerous reports have linked IFIS to multiple risk factors including age, gender, hypertension, and the use of adrenergic alpha-1 receptor antagonists,\n most notably tamsulosin. Tamsulosin selectively blocks the adrenergic alpha-1 receptor in the iris dilator muscle, preventing mydriasis during cataract surgery. Other adrenergic alpha-1 receptor antagonists, including terazosin, doxazosin, alfuzosin, and sildosin, have also been linked to\n IFIS; however, their relationship to IFIS is not as well defined.  <jats:bold>Conclusion<\/jats:bold> Patients should be educated regarding potential adverse effects and discuss this with their health care providers prior to cataract surgery. In addition, health care providers should be aware of\n the adverse effect and take steps to reduce the risk of surgical complications.<\/jats:p>","DOI":"10.4140\/tcp.n.2022.227","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T04:38:02Z","timestamp":1653453482000},"page":"227-231","source":"Crossref","is-referenced-by-count":3,"title":["Alpha Blocker-Associated Intraoperative Floppy Iris Syndrome"],"prefix":"10.4140","volume":"37","author":[{"given":"Maha","family":"Saad","sequence":"first","affiliation":[{"name":"St. John's University, College of Pharmacy and Health Sciences, Queens, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Maisch","sequence":"additional","affiliation":[{"name":"St. John's University, College of Pharmacy and Health Sciences, Queens, New York."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"issue":"22","key":"ref1","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.21037\/atm-20-3214","article-title":"A narrative review of intraoperative floppy iris syndrome: an update 2020.","volume":"8","year":"2020","journal-title":"Ann Transl Med."},{"key":"ref2","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.ophtha.2013.10.031","article-title":"Prospective masked comparison of intraoperative floppy iris syndrome severity with tamsulosin versus alfuzosin.","volume":"121","year":"2014","journal-title":"Ophthalmology."},{"key":"ref3","doi-asserted-by":"crossref","first-page":"463","DOI":"10.2147\/OPTH.S221094","article-title":"Intraoperative floppy iris syndrome: updated perspectives.","volume":"14","year":"2020","journal-title":"Clin Ophthalmol."},{"issue":"3","key":"ref4","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1007\/s10792-018-0840-3","article-title":"Clinical risk factors associated with intraoperative floppy iris syndrome: a prospective study.","volume":"39","year":"2019","journal-title":"Int Ophthalmol."},{"issue":"4","key":"ref5","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/j.ophtha.2010.08.039","article-title":"Risk factors for intraoperative floppy iris syndrome: a meta-analysis.","volume":"118","year":"2011","journal-title":"Ophthalmology."},{"issue":"9","key":"ref6","doi-asserted-by":"crossref","first-page":"3766","DOI":"10.1167\/iovs.06-0153","article-title":"Influence of tamsulosin on the iris and its implications for cataract surgery.","volume":"47","year":"2006","journal-title":"Invest Ophthalmol Vis Sci."},{"issue":"5","key":"ref7","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.ophtha.2007.01.011","article-title":"Prospective multicenter evaluation of cataract surgery in patients taking tamsulosin (Flomax).","volume":"114","year":"2007","journal-title":"Ophthalmology."},{"issue":"4","key":"ref8","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.jcrs.2006.11.019","article-title":"Intraoperative floppy-iris syndrome with doxazosin.","volume":"33","year":"2007","journal-title":"J Cataract Refract Surg."},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1001\/jama.2009.683","article-title":"Association between tamsulosin and serious ophthalmic adverse events in older men following cataract surgery.","volume":"301","year":"2009","journal-title":"JAMA."},{"issue":"6","key":"ref10","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1007\/s00417-013-2260-4","article-title":"Intraoperative floppy iris syndrome (IFIS) in patients receiving tamsulosin or doxazosin\u2014a UK-based comparison of incidence and complication rates.","volume":"251","year":"2013","journal-title":"Graefes Arch Clin Exp Ophthalmol."},{"issue":"8","key":"ref11","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1038\/eye.2016.122","article-title":"Risk factors for intraoperative floppy iris syndrome: a prospective study.","volume":"30","year":"2016","journal-title":"Eye (Lond)."},{"key":"ref12","volume-title":"Tamsulosin package insert.","year":"2019"},{"key":"ref13","article-title":"Alpha-Blocker Patient Advisory\u20142014. American Academy of Ophthalmology."},{"issue":"1","key":"ref14","first-page":"98","article-title":"Ten years of intraoperative floppy iris syndrome in the era of alpha-blockers.","volume":"71","year":"2018","journal-title":"Cent European J Urol."}],"container-title":["The Senior Care Pharmacist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/ascp\/tscp\/2022\/00000037\/00000006\/art00005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T04:32:29Z","timestamp":1653798749000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.4140\/TCP.n.2022.227"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,1]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6,1]]}},"alternative-id":["2639-9636(20220601)37:6L.227;1-"],"URL":"https:\/\/doi.org\/10.4140\/tcp.n.2022.227","relation":{},"ISSN":["2639-9636"],"issn-type":[{"value":"2639-9636","type":"print"}],"subject":[],"published":{"date-parts":[[2022,6,1]]}}}