Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases

Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Fo...
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Autor*in:	Ya-Hui Wang [verfasserIn] Liang-Chen Huang [verfasserIn] Sung Huang Laurent Tsai [verfasserIn] Ying-Jen Chen [verfasserIn] Chien-Liang Wu [verfasserIn] Yi-No Kang [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin

Übergeordnetes Werk:	In: Frontiers in Medicine - Frontiers Media S.A., 2014, 9(2022)
Übergeordnetes Werk:	volume:9 ; year:2022

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fmed.2022.941130

Katalog-ID:	DOAJ024160865

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allfields	10.3389/fmed.2022.941130 doi (DE-627)DOAJ024160865 (DE-599)DOAJ6f66ae9953d7460b8b12fdaa12b585b7 DE-627 ger DE-627 rakwb eng R5-920 Ya-Hui Wang verfasserin aut Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter. phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin Medicine (General) Ya-Hui Wang verfasserin aut Liang-Chen Huang verfasserin aut Sung Huang Laurent Tsai verfasserin aut Sung Huang Laurent Tsai verfasserin aut Ying-Jen Chen verfasserin aut Ying-Jen Chen verfasserin aut Chien-Liang Wu verfasserin aut Chien-Liang Wu verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.941130 kostenfrei https://doaj.org/article/6f66ae9953d7460b8b12fdaa12b585b7 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.941130/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022
spelling	10.3389/fmed.2022.941130 doi (DE-627)DOAJ024160865 (DE-599)DOAJ6f66ae9953d7460b8b12fdaa12b585b7 DE-627 ger DE-627 rakwb eng R5-920 Ya-Hui Wang verfasserin aut Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter. phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin Medicine (General) Ya-Hui Wang verfasserin aut Liang-Chen Huang verfasserin aut Sung Huang Laurent Tsai verfasserin aut Sung Huang Laurent Tsai verfasserin aut Ying-Jen Chen verfasserin aut Ying-Jen Chen verfasserin aut Chien-Liang Wu verfasserin aut Chien-Liang Wu verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.941130 kostenfrei https://doaj.org/article/6f66ae9953d7460b8b12fdaa12b585b7 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.941130/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022
allfields_unstemmed	10.3389/fmed.2022.941130 doi (DE-627)DOAJ024160865 (DE-599)DOAJ6f66ae9953d7460b8b12fdaa12b585b7 DE-627 ger DE-627 rakwb eng R5-920 Ya-Hui Wang verfasserin aut Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter. phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin Medicine (General) Ya-Hui Wang verfasserin aut Liang-Chen Huang verfasserin aut Sung Huang Laurent Tsai verfasserin aut Sung Huang Laurent Tsai verfasserin aut Ying-Jen Chen verfasserin aut Ying-Jen Chen verfasserin aut Chien-Liang Wu verfasserin aut Chien-Liang Wu verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.941130 kostenfrei https://doaj.org/article/6f66ae9953d7460b8b12fdaa12b585b7 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.941130/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022
allfieldsGer	10.3389/fmed.2022.941130 doi (DE-627)DOAJ024160865 (DE-599)DOAJ6f66ae9953d7460b8b12fdaa12b585b7 DE-627 ger DE-627 rakwb eng R5-920 Ya-Hui Wang verfasserin aut Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter. phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin Medicine (General) Ya-Hui Wang verfasserin aut Liang-Chen Huang verfasserin aut Sung Huang Laurent Tsai verfasserin aut Sung Huang Laurent Tsai verfasserin aut Ying-Jen Chen verfasserin aut Ying-Jen Chen verfasserin aut Chien-Liang Wu verfasserin aut Chien-Liang Wu verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.941130 kostenfrei https://doaj.org/article/6f66ae9953d7460b8b12fdaa12b585b7 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.941130/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022
allfieldsSound	10.3389/fmed.2022.941130 doi (DE-627)DOAJ024160865 (DE-599)DOAJ6f66ae9953d7460b8b12fdaa12b585b7 DE-627 ger DE-627 rakwb eng R5-920 Ya-Hui Wang verfasserin aut Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter. phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin Medicine (General) Ya-Hui Wang verfasserin aut Liang-Chen Huang verfasserin aut Sung Huang Laurent Tsai verfasserin aut Sung Huang Laurent Tsai verfasserin aut Ying-Jen Chen verfasserin aut Ying-Jen Chen verfasserin aut Chien-Liang Wu verfasserin aut Chien-Liang Wu verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut Yi-No Kang verfasserin aut In Frontiers in Medicine Frontiers Media S.A., 2014 9(2022) (DE-627)789482991 (DE-600)2775999-4 2296858X nnns volume:9 year:2022 https://doi.org/10.3389/fmed.2022.941130 kostenfrei https://doaj.org/article/6f66ae9953d7460b8b12fdaa12b585b7 kostenfrei https://www.frontiersin.org/articles/10.3389/fmed.2022.941130/full kostenfrei https://doaj.org/toc/2296-858X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 9 2022
language	English
source	In Frontiers in Medicine 9(2022) volume:9 year:2022
sourceStr	In Frontiers in Medicine 9(2022) volume:9 year:2022
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin Medicine (General)
isfreeaccess_bool	true
container_title	Frontiers in Medicine
authorswithroles_txt_mv	Ya-Hui Wang @@aut@@ Liang-Chen Huang @@aut@@ Sung Huang Laurent Tsai @@aut@@ Ying-Jen Chen @@aut@@ Chien-Liang Wu @@aut@@ Yi-No Kang @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
hierarchy_top_id	789482991
id	DOAJ024160865
language_de	englisch
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callnumber-first	R - Medicine
author	Ya-Hui Wang
spellingShingle	Ya-Hui Wang misc R5-920 misc phacoemulsification surgery misc cataract surgery misc intraoperative floppy iris syndrome misc prostate hyperplasia misc α1-antagonists misc tamsulosin misc Medicine (General) Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases
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topic_title	R5-920 Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases phacoemulsification surgery cataract surgery intraoperative floppy iris syndrome prostate hyperplasia α1-antagonists tamsulosin
topic	misc R5-920 misc phacoemulsification surgery misc cataract surgery misc intraoperative floppy iris syndrome misc prostate hyperplasia misc α1-antagonists misc tamsulosin misc Medicine (General)
topic_unstemmed	misc R5-920 misc phacoemulsification surgery misc cataract surgery misc intraoperative floppy iris syndrome misc prostate hyperplasia misc α1-antagonists misc tamsulosin misc Medicine (General)
topic_browse	misc R5-920 misc phacoemulsification surgery misc cataract surgery misc intraoperative floppy iris syndrome misc prostate hyperplasia misc α1-antagonists misc tamsulosin misc Medicine (General)
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title	Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases
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title_full	Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases
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author_browse	Ya-Hui Wang Liang-Chen Huang Sung Huang Laurent Tsai Ying-Jen Chen Chien-Liang Wu Yi-No Kang
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title_sort	risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—a consistency model of 6,488 cases
callnumber	R5-920
title_auth	Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases
abstract	Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter.
abstractGer	Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter.
abstract_unstemmed	Selective α1-blockers are commonly administered to patients with lower urinary tract syndrome and benign prostatic hyperplasia, but may increase the risk of intraoperative floppy iris syndrome (IFIS). The purpose of this study aimed to clarify the risk of IFIS among various selective α1-blockers. Four databases were searched for prospective studies comparing alpha-1-antagonists. Data were pooled using the consistency model, and used risk ratio (RR) and mean difference (MD) for IFIS and pupil diameter, respectively. This study finally included 25 prospective comparative studies. Based on 51 direct comparisons with 6488 cases, risks of IFIS in patients who received tamsulosin [RR, 13.85; 95% confidence interval (CI): 7.34 to 26.11], terazosin (RR, 8.94; 95% CI 2.88 to 27.74), alfuzosin (RR, 7.73; 95% CI: 3.05 to 19.62), and doxazosin (RR, 3.88; 95% CI: 1.13 to 13.28) were significantly higher than those did not receive α1-antagonists. Based on 11 direct comparisons with 564 cases, as compared to no α1-antagonists, patients who received tamsulosin (MD, −0.36; 95% CI: −0.71 to −0.01) and alfuzosin (MD, −0.34; 95% CI: −0.62 to −0.07) showed smaller pupil diameter under mesopic light levels, while those received silodosin did not show significantly smaller mesopic pupil diameter than people without α1-antagonists. IFIS seems to be inevitable with the usage of α1-antagonists, and tamsulosin needs to be cautious due to the significantly higher risk of severe IFIS. With regard to silodosin, there is no strong evidence to support the uses of italthough it does not significantly decrease mesopic pupil diameter.
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title_short	Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases
url	https://doi.org/10.3389/fmed.2022.941130 https://doaj.org/article/6f66ae9953d7460b8b12fdaa12b585b7 https://www.frontiersin.org/articles/10.3389/fmed.2022.941130/full https://doaj.org/toc/2296-858X
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Risk of intraoperative floppy iris syndrome among selective alpha-1 blockers—A consistency model of 6,488 cases

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