Ophthalmology, urology societies unite to raise IFIS awareness

The American Society of Cataract and Refractive Surgery (ASCRS), the American Academy of Ophthalmology (AAO), and the American Urological Association (AUA) have joined forces to launch a patient and prescriber education campaign about the risk of intraoperative floppy iris syndrome (IFIS) associated with the current or previous use of an alpha-1 blocker and the likelihood of successful surgery if the ophthalmologist is aware of that medication history and is able to employ appropriate surgical strategies.

On Aug. 22, 2006, the triad of professional societies sponsored a media conference call and issued a press release to alert physicians who prescribe alpha-1 blockers and the patients who are taking them that it is important to inform the ophthalmologist about such use prior to undergoing cataract surgery. Alpha-1 blockers include tamsulosin (Flomax, Boehringer Ingelheim), terazosin HCl (Hytrin, Abbott), doxazosin mesylate (Cardura), and alfuzosin HCl (Uroxatral, Sanofi-Syntholabo).

"Our efforts today are aimed primarily at the public, and so we are very happy to see that the story has been picked up by a major newswire," he continued. "AUA leaders will be assessing how to educate their own members better, and we also need to reach out to other prescribers. Certainly, however, we expect that patient inquiries to their personal physicians stimulated by media reports will have a powerful role in raising prescriber awareness."

As a second objective, the three spokes-persons aimed to disseminate the reassuring message that cataract surgery can be performed safely if the ophthalmologist is aware of the potential for IFIS so that he or she is able to use appropriate techniques for managing the floppy iris. That information is based on the results of a multicenter study conducted at 10 clinical sites and enrolling more than 160 eyes in patients taking tamsulosin.

In the study, a variety of management techniques could be used, and selection was left to the discretion of each investigator. The study's results showed that compared with routine cataract surgery in patients not taking an alpha-1 blocker, surgical outcomes were similarly excellent and complication rates similarly low.