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Unexpected IFIS: Avoiding a Challenging Case

An unsatisfied cataract patient presents with red blood cells between the optic and posterior capsule and multiple microsphincterotomies. Prior to surgery, the patient was taking Flomax and Coumadin which likely compounded the intraoperative floppy iris syndrome. Dr. Steven Dewey presents his steps to help catch the evasive IFIS patient and prepare the surgeon for that unexpected, worsening scenario.

Comments (5)

Is the Dewey radius tip available for purchase in india ? I am using a AMO Sovereign Compact machine with Ellips FX handpiece. Does the Dewey tip work for this machine ?

(13 months ago)

intra-cameral 0.6 ml of 1.5% unpreserved phenylephrine works well in this scenario, even after capsulorhexis, in providing more mydriasis and stabilizing the iris

mea2020 (51 months ago)

I think all small pupils should be accepted IFIS case except pseudoexfoliation syndrome

azizcil (82 months ago)

very difficult, I can't do it.

Prasertc (83 months ago)

hmm. this case scares me. too much being done w/o good visualization. can't see the rhexis, cant see where my 2nd instrument is going. i think "regular" surgeons like me would put in hooks. i think only very advanced surgeons can operate like this and not get into trouble.

ranchump62 (83 months ago)