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Silodosin as a predisposing factor of intraoperative floppy iris syndrome (IFIS): an observational propensity score-matching cohort study

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Abstract

Purpose

To evaluate the correlation between silodosin and intraoperative floppy iris syndrome (IFIS) and compare it with other a1-adrenergic receptor antagonists (a1-ARAs) and other factors predisposing to IFIS.

Methods

From the patients who underwent phacoemulsification between 2014 and 2020, we identified all patients who, during their preoperative assessment, reported an a1-ARAs intake (exposed group). These patients were matched utilizing a propensity score matching analysis with an otherwise homogenous group of patients (control group) based on demographics and systemic/ocular comorbidities.

Results

A total of 350 patients were included in each group. In the exposed group, 177 (50.6%) patients were exposed to tamsulosin, 105 (30%) to alfuzosin, 43 (12.2%) to silodosin. Regarding IFIS, it was observed in 21.5% of patients on tamsulosin (38/177), 11.4% on alfuzosin (12/105), 37.2% on silodosin (16/43), and 3.4% in the controlled group (12/350). In a multiple regression model analysis, the only two factors significantly associated with IFIS development were silodosin and tamsulosin yielding an adjusted odds ratio of 8.471 (95%CI 4.005–17.920) and 3.803 (95%CI 2.231–6.485), respectively.

Conclusion

Silodosin has been demonstrated as a predisposing factor, strongly correlated with IFIS development. These results should increase cataract surgeons’ awareness to assess their patients preoperatively for exposure to silodosin carefully and employ the appropriate prophylactic measures to ameliorate the impact of silodosin intake on the surgical outcome.

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Funding

No funding was received for this research. No financial grants or funds were received in support of the study.

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Authors and Affiliations

  1. 2nd Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Chrysanthos D. Christou, Marianna Kourouklidou, Asimina Mataftsi, Eirini Oustoglou, Nikolaos Ziakas & Argyrios Tzamalis

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  1. Chrysanthos D. Christou
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  2. Marianna Kourouklidou
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  3. Asimina Mataftsi
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  4. Eirini Oustoglou
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  6. Argyrios Tzamalis
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Correspondence to Argyrios Tzamalis.

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Christou, C.D., Kourouklidou, M., Mataftsi, A. et al. Silodosin as a predisposing factor of intraoperative floppy iris syndrome (IFIS): an observational propensity score-matching cohort study. Int Ophthalmol 42, 393–399 (2022). https://doi.org/10.1007/s10792-021-02054-y

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