Preoperative atropine and non-steroidal anti-inflammatory drugs for the prevention of intraoperative floppy iris syndrome.
Adrenergic alpha-1 Receptor Antagonists
/ adverse effects
Aged
Aged, 80 and over
Anti-Inflammatory Agents
Anti-Inflammatory Agents, Non-Steroidal
/ adverse effects
Atropine
Humans
Incidence
Intraoperative Complications
/ prevention & control
Iris
Iris Diseases
/ chemically induced
Male
Phacoemulsification
/ methods
Pharmaceutical Preparations
Retrospective Studies
Sulfonamides
Tamsulosin
Atropine
Cataract surgery
Intraoperative floppy eyelid syndrome
Non-steroidal anti-inflammatory drugs
Journal
Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie
ISSN: 1435-702X
Titre abrégé: Graefes Arch Clin Exp Ophthalmol
Pays: Germany
ID NLM: 8205248
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
29
05
2021
accepted:
01
10
2021
revised:
29
09
2021
pubmed:
16
10
2021
medline:
19
2
2022
entrez:
15
10
2021
Statut:
ppublish
Résumé
To examine the efficacy of preoperative administration of topical atropine 1% and non-steroidal anti-inflammatory drugs (NSAIDs) for prevention of intraoperative floppy iris syndrome (IFIS). In this retrospective cohort study, patients who underwent cataract surgery by phacoemulsification between July 2019 and February 2020 in two hospitals were included. Both hospitals are located in central Israel, have similar patient demographics and employ similar surgical techniques. They, however, differ in policy of IFIS prevention. In Meir Medical Center no preventive medications are given pre-operatively, while in Shamir Medical Center patients at-risk for IFIS receive topical atropine 1% once daily and non-steroidal anti-inflammatory drugs (NSAIDs) thrice daily for 3 days preoperatively. Overall, 207 eyes of 207 patients with history of alpha-antagonist use were included. Mean age was 74.9 ± 7.8 years and 82.1% (n = 170) were male. Among patients from the pretreating center 86.8% (n = 92/106) were pre-treated with either NSAIDs or atropine preoperatively, while in the non-pretreating center no treatment was prescribed (n = 0/101). IFIS rate among the non-pretreating center was 29.7% (n = 30/101) compared to 15.1% (n = 16/106) in the pretreating center (p = 0.012). When strictly comparing treated to untreated patients, the treated group had an IFIS rate of 12.0% compared to 30.4% among untreated (p = 0.001). Adjusted for age and gender results remain consistent (odds ratio 0.329 for treated patients, 95% confidence interval: 0.150-0.720; p = 0.005). IFIS rates were significantly lower in the pretreating center compared to the non-pretreating center. When comparing strictly treated to untreated patients, differences were even more pronounced.
Identifiants
pubmed: 34652535
doi: 10.1007/s00417-021-05444-1
pii: 10.1007/s00417-021-05444-1
doi:
Substances chimiques
Adrenergic alpha-1 Receptor Antagonists
0
Anti-Inflammatory Agents
0
Anti-Inflammatory Agents, Non-Steroidal
0
Pharmaceutical Preparations
0
Sulfonamides
0
Atropine
7C0697DR9I
Tamsulosin
G3P28OML5I
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
893-900Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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