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Safety and efficacy of intra‐operative sub‐Tenon injection of 2% lidocaine in cases of unexpected intra‐operative floppy iris syndrome (IFIS)
Author(s) -
KLYSIK A,
KORZYCKA D
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.1774.x
Subject(s) - medicine , lidocaine , cataract surgery , iris (biosensor) , pupil , surgery , miosis , anesthesia , ophthalmology , computer security , neuroscience , computer science , biometrics , biology
Purpose To report safety and efficacy of intra‐operative injection of 2% lidocaine during small incision cataract surgery in cases of unexpected intra‐operative floppy iris syndrome. Methods 4 patients, undergoing routine cataract surgery, who were exposed to alfa‐adrenergic inhibitors, and it was not known pre‐operatively, and in whom intra‐operative floppy iris syndrome occurred unexpectedly. 2.5 ml of 2% lidocaine was injected into the sub‐Tenon space in response to intra‐operative iris prolapse and pupillary constriction. Injection was performed following hydrodissection in 3 of 4 cases and hollowing capsulorrhexis in 1 of 4 cases. The surgery was video‐taped from the beginning of the injection. Results No further iris prolapse was noted in any case, nor further pupillary constriction. Iris plane was stabilized. There were no further complications of cataract surgery. Patients were comfortable and pain free for the rest of the procedure. Conclusion Intra‐operative injection of 2% lidocaine into the sub‐Tenon space is a safe way of reversing iris floppiness and the tendency to iris prolapsed in cases of unexpected intra‐operative floppy iris syndrome. It is an alternative to other intra‐operative techniques to manage IFIS, which provides pain relief as well as iris stabilization.