Intraoperative floppy iris syndrome (IFIS) is a complication that may occur during cataract extraction in certain patients. This syndrome is characterized by a flaccid iris

Iris (anatomy)

The iris is a thin, circular structure in the eye, responsible for controlling the diameter and size of the pupils and thus the amount of light reaching the retina. "Eye color" is the color of the iris, which can be green, blue, or brown. In some cases it can be hazel , grey, violet, or even pink...

 which billows in response to ordinary intraocular fluid currents, a propensity for this floppy iris to prolapse towards the area of cataract extraction during surgery, and progressive intraoperative pupil

Pupil

The pupil is a hole located in the center of the iris of the eye that allows light to enter the retina. It appears black because most of the light entering the pupil is absorbed by the tissues inside the eye. In humans the pupil is round, but other species, such as some cats, have slit pupils. In...

 constriction despite standard procedures to prevent this.

IFIS has been associated with Flomax (tamsulosin

Tamsulosin

Tamsulosin is an α1a-selective alpha blocker used in the symptomatic treatment of benign prostatic hyperplasia . Tamsulosin was developed by Yamanouchi Pharmaceuticals and is marketed by various companies under licence, including Boehringer-Ingelheim and CSL...

), a medication widely prescribed for urinary symptoms associated with benign prostatic hyperplasia

Benign prostatic hyperplasia

Benign prostatic hyperplasia also known as benign prostatic hypertrophy , benign enlargement of the prostate , and adenofibromyomatous hyperplasia, refers to the increase in size of the prostate....

. Tamsulosin is a selective alpha blocker

Alpha blocker

Alpha-1 blockers constitute a variety of drugs which block α1-adrenergic receptors in arteries and smooth muscles.-Pharmacology:...

 that works by relaxing the bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

 and prostatic smooth muscle. As such, it also relaxes the iris dilator muscle

Iris dilator muscle

The iris dilator muscle , is a smooth muscle of the eye, running radially in the iris and therefore fit as a dilator. It has its origin from the anterior epithelium. It is innervated by the sympathetic system, which acts by releasing noradrenaline, which acts on α1-receptors...

 by binding to its postsynaptic nerve endings.

IFIS may also be associated with other causes of small pupil like synechiae, pseudoexfoliation and other medications (used for conditions such as glaucoma

Glaucoma

Glaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye and progressing to complete blindness if untreated. It is often, but not always, associated with increased pressure of the fluid in the eye...

, diabetes and high blood pressure). IFIS does not usually cause significant changes in postoperative outcomes. Patients may experience more pain, a longer recovery period, and less improvement in visual acuity than a patient with an uncomplicated cataract removal.

The severity of the condition is not linked to the duration of tamsulosin intake.