[en] Purpose: To determine the grade and incidence of intraoperative floppy iris syndrome (IFIS) in patients who are under treatment with tamsulosine and are performed cataract extraction surgery through phacoemulsification, compared to patients with the same characteristics but who are not applied intracameral phenylephrine during phacoemulsification. Methods: The files of all the patients who were done cataract surgery extraction through phacoemulsification from January 2009 to July 2010 were checked. Previously, the patients who were under treatment with tamsulosine were identified and to these latter two groups were established under the basis of a case-control study: the cases were the patients that were treated transurgically with intracameral phenylephrine and the controls were the patients with the same conditions but that were not treated with transurgical intracameral phenylephrine. IFIS was defined and classified by the presence of any phenomena that constitute this syndrome (iris ondulation, iris prolapse through the wounds and pupillary constriction). The surgical time, surgical incidents and complications were registered. Results: With a total of 3156 cataract surgeries, 100 eye surgical interventions were identified of 64 patients who were taking tamsulosine at the moment of the surgery. In the total of the surgical interventions, the incidence of tamsulosine intake was 3.1%. 70 eyes received prophylaxis with intracameral phenylephrine and the IFIS incidence was of 12%. Out of this 12%, 9% was grade 1, and 3% grade 2. 28 eyes that did not receive intracameral pheyleprhine presented and IFIS incidence of 68%, with 11% being grade 1, 29% grade 2 and 18% grade 3. On the other hand, 2 eyes were excluded from the final analysis because of iris hooks use at the beginning of the surgery. As part of the complications reported, posterior capsular rupture with vitreous loss was present in 2 eyes that presented grade 3 IFIS, and none of these were treated with prophylactic intracameral phenylephrine. The patients that were not treated with prophylactic intracameral phenylephrine presented longer time in the surgical intervention, with an average of an excess of 3 minutes. On the other hand, the higher the grade of the IFIS, the longer was the surgical time. Conclusions: The incidence of IFIS in the group without phenylephrine was similar to the one reported in other publications. The latter presented 5.77 times more risk of presenting IFIS. The use of prophylactic intracameral phenylephrine significantly reduced the grade and incidence of IFIS. In this group the surgical time was less and no complications were presented. The data obtained was compared with other publications with similar results. Financial disclosure: The authors of this study do not have financial interests.

[es] Propósito: Determinar en intervenciones de facoemulsificación de pacientes que toman tamsulosina el efecto de la profilaxis de la fenilefrina intracameral sobre la incidencia y el grado de síndrome del iris fláccido intraoperatorio comparado con no recibir la fenilefrina intracameral. Métodos: Se revisaron todas las historias clínicas de los pacientes que se operaron de cataratas por facoemulsificación entre enero de 2009 y julio de 2010. Se detectaron previamente los pacientes que tomaban tamsulosina y se decidió establecer un grupo con fenilefrina intracameral (casos) y otro grupo sin fenilefrina (controles). El IFIS se definió y clasificó por la presencia de cualquiera de los tres fenómenos que constituyen el síndrome (ondulación del iris, prolapso del iris y la constricción pupilar). Se registraron los tiempos quirúrgicos, incidencias y complicaciones. Resultados: Se identificaron con una revisión de 3156 intervenciones de catarata, 100 intervenciones de 64 pacientes que tomaban tamsulosina en el momento de la cirugía. Se determinó una incidencia de toma de tamsulosina de 3,1% en el total de las intervenciones. 70 ojos recibieron profilaxis con fenilefrina intracameral y la incidencia de IFIS fue del 12%, presentándose el 9% en grado 1 y el 3% en grado 2. 28 ojos no recibieron fenilefrina intracameral y la incidencia de IFIS fue del 68%, presentándose el 11% en grado 1, el 39% en grado 2 y el 18% en grado 3. Por otro lado, 2 ojos se excluyeron del análisis final por la utilización de ganchos retractores del iris al inicio de la intervención, imposibilitando valorar la presencia de IFIS. Se reportaron como complicaciones en 2 ojos la rotura de la cápsula posterior con pérdida del vítreo (2%), estos casos correspondían a ojos que no recibieron fenilefrina intracameral y que presentaron grado 3. Se observaron tiempos quirúrgicos más prolongados en los ojos sin fenilefrina intracameral, que necesitaron 3 minutos más de media. Por otro lado a mayor grado de IFIS fue necesario mayor tiempo quirúrgico para finalizar la intervención. Conclusiones: La incidencia de IFIS en el grupo sin fenilefrina fue similar a otras publicaciones. Los ojos sin fenilefrina intracameral presentaron 5,77 veces más riesgo de desarrollar IFIS. El uso profiláctico de fenilefrina intracameral redujo la incidencia y el grado de IFIS. En este grupo el tiempo quirúrgico fue menor y no se produjeron complicaciones. Se compararon los datos obtenidos con publicaciones con resultados comparables. Divulgación financiera: No hay ningún interés financiero en cualquier material o método mencionado.