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To evaluate the efficacy of calibrated side port incision in preventing progression of Intraoperative Floppy Iris Syndrome
Randomised prospective study was done between January 2018 and April 2019 in 105 patients undergoing Phacoemulsification using Tamsulosin with dilated pupillary diameter of more than 5.0 mm. Tropicamide 0.8%(with/without phenylephrine 5%) and Flubiprofen eye drops0.03% were used pre operatively. Intracameral epinephrine was used to dilate the pupil. Surgical technique of long anterior corneal tunnel, gentle hydrodissection, visco mydriasis with sodium hyaluronate 2.3%, active fluidics with low 38 mm IOP, iris plane nuclear emulsification, switching continuous irrigation off and gentle stromal hydration was used. Calibrated side port incision with 25 G needle & calibrated chopper was used.
Side port calibration decreased chamber fluctuation. Subsequently, the decreased flow of BSS in the posterior aspect of iris reduced iris billowing and trauma to iris. Parameters studied were iris billowing, iris prolapse, pupillary constriction, and change in pupillary size pre and post phacoemulsification. There was no IFIS observed in 38 eyes, 67 eyes had iris billowing, no eye had iris prolapse or progressive pupillary constriction. The change in mean pupillary diameter observed was 0.8 mm +/- 0.56 mm.
The addition of calibrated side port incision to the surgical protocols used in Tamsulosin patients allows stable anterior chamber settings, thereby preventing IFIS progression.