Modified Surgical Techniques for Managing Intraoperative Floppy Iris Syndrome

Area of Science:

• Ophthalmology
• Surgical Innovation

Background:

• Intraoperative floppy iris syndrome (IFIS) presents challenges during cataract surgery, particularly iris prolapse and inadequate pupil dilation.
• Managing IFIS-associated iris prolapse requires specialized surgical strategies to ensure patient safety and procedural success.

Purpose of the Study:

• To present a modified surgical strategy for managing intraoperative floppy iris syndrome-associated iris prolapse.
• To offer an alternative technique for surgeons dealing with IFIS complications.

Main Methods:

• A novel approach involves leaving prolapsed iris in situ and creating a new corneal incision at a different site.
• This additional incision serves as a new port for phacoemulsification or a secure site for iris prolapse, facilitating safe surgery.
• Adjunctive use of iris retractors was employed to enhance the surgical workspace.

Main Results:

• The modified technique was successfully applied in two cases of IFIS with iris prolapse and poor pupil dilation.
• Cataract surgery proceeded without further complications in both reported cases.
• The technique effectively managed iris prolapse and allowed for adequate workspace during phacoemulsification.

Conclusions:

• The described surgical technique provides an effective adjunct for managing IFIS-associated iris prolapse.
• This strategy expands the surgical armamentarium available for addressing IFIS complications during cataract surgery.
• The modified approach contributes to safer and more manageable outcomes in challenging cataract surgeries.