Floppy Iris Cataract Surgery: Surgical Pearls for Beginning Surgeons скачать в хорошем качестве

Floppy Iris Cataract Surgery: Surgical Pearls for Beginning Surgeons

Surgical video on how to manage the unexpected floppy iris with small pupil during cataract surgery: Simple Pearls for Beginning Surgeons. The risks of Floppy Iris Syndrome (IFIS) in cataract patients who take alpha-blockers preoperatively have been extensively studied over the past decade since it was first reported (Chang DF Intraoperative floppy iris syndrome associated with tamsulosin (Flomax). J Cataract Refract Surgery 2005; 31:664-673). A review of 1254 patients at the VA with IFIS revealed 86 patients (6.8%) had at least 1 intraoperative complication and 39 (3%) had more than 1 intraoperative complication (Vollman et al. Am J Ophhhalmol. 2014 Jun; 157(6):1130-1135. Ideally, an iris retraction device (e.g. Malyugian, Visitec iRing, iris hooks, etc) should be used before the rhexis step so as to not inadvertently damage an open rhexis during placement. But what do you do when the pupil shrinks mid-way through the phaco step? In this video, five simple pearls for managing the floppy iris during cataract surgery are discussed. The case presented is a monocular patient with unexpected small pupil during cataract. In this particular situation, the decision was made to stage the surgery and come back 1 week later to allow for safer placement of iris hooks when better visualization of the anterior rhexis could be achieved.