Which medication is associated with intraoperative floppy iris syndrome?

Which medication is associated with intraoperative floppy iris syndrome?

• A. Flomax
• B. Latanoprost
• C. Timolol
• D. Pilocarpine

Answer: (A)

Intraoperative floppy iris syndrome occurs when the iris dilator muscle loses tone due to alpha-adrenergic blockade, causing the iris to billow and the pupil to become unstable during cataract surgery. The medication most strongly linked to this is Flomax, which is tamsulosin, an alpha-1A selective blocker used for BPH. By blocking alpha-1A receptors in the iris, tamsulosin reduces the muscle’s ability to maintain pupil size, leading to a floppy iris that can constrict or prolapse as the surgeon works. The other drugs listed don’t cause this syndrome: latanoprost is a prostaglandin analogue affecting aqueous humor outflow, timolol is a beta-blocker reducing aqueous production, and pilocarpine is a muscarinic agonist that causes miosis; none create the characteristic floppy iris during surgery.

Intraoperative floppy iris syndrome occurs when the iris dilator muscle loses tone due to alpha-adrenergic blockade, causing the iris to billow and the pupil to become unstable during cataract surgery. The medication most strongly linked to this is Flomax, which is tamsulosin, an alpha-1A selective blocker used for BPH. By blocking alpha-1A receptors in the iris, tamsulosin reduces the muscle’s ability to maintain pupil size, leading to a floppy iris that can constrict or prolapse as the surgeon works. The other drugs listed don’t cause this syndrome: latanoprost is a prostaglandin analogue affecting aqueous humor outflow, timolol is a beta-blocker reducing aqueous production, and pilocarpine is a muscarinic agonist that causes miosis; none create the characteristic floppy iris during surgery.