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Pediatric intraoperative floppy-iris syndrome

M Edward Wilson1, Rupal H Trivedi, Susannah Mistr

  • 1Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina 29425-5536, USA. wilsonme@musc.edu

Journal of Cataract and Refractive Surgery
|June 26, 2007
PubMed

Insights

Epinephrine in irrigating solution prevented intraoperative floppy-iris syndrome (IFIS) during pediatric cataract surgery. This finding underscores the importance of epinephrine for preventing IFIS in infants.

Area of Science:

  • Ophthalmology
  • Pediatric Surgery

Background:

  • Congenital cataracts require surgical intervention in infants.
  • Intraoperative floppy-iris syndrome (IFIS) is a known complication during cataract surgery.

Observation:

  • A 4-month-old infant underwent bilateral congenital cataract removal.
  • IFIS signs, including iris floppiness and prolapse, occurred in the left eye but not the right.
  • Epinephrine was omitted from the left eye's irrigating solution but used in the right.

Findings:

  • Intracameral epinephrine in the irrigating solution effectively prevented IFIS in the infant's right eye.
  • The omission of epinephrine in the left eye's irrigation correlated with the development of IFIS.

Implications:

  • This case highlights the critical role of intracameral epinephrine in preventing IFIS during pediatric cataract surgery.
  • Standardizing the use of epinephrine in pediatric cataract surgery irrigation may reduce intraoperative complications.

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