J Korean Ophthalmol Soc.  2012 Feb;53(2):256-261.

The Effect of alpha1-Adrenergic Blocker on Phacoemulsification

• Kim EK
• Chung SK
• Baek NH

Abstract

PURPOSE
To evaluate the influence of alpha1-adrenergic blocker on phacoemulsification and the preventive effect of adrenergic blocker (AB) cessation before cataract surgery.
METHODS
A prospective study was performed involving 92 eyes of 60 patients undergoing cataract surgery. Cases were divided into three groups: the use of alpha1AB with discontinuance before surgery (32 eyes), the use of alpha1AB with no discontinuance before surgery before surgery (31 eyes), and eyes not treated with alpha1AB (29 eyes). Clinical measurements and intraoperative parameters were compared among the three groups.
RESULTS
Preoperative maximum pupil diameters of patients treated with alpha1AB were smaller than those of patients not administered alpha1AB (p = 0.027 and p = 0.018, respectively). The incidence of IFIS in the patients using of alpha1AB with discontinuance before surgery was 6.25%, and that in the patients using of alpha1AB with no discontinuance before surgery was 6.45%. There was no IFIS outbreak in the patients not using of alpha1AB. We noted no significant differences in absolute phaco time during phacoemulsification (p = 0.207) or in the three-month postoperative best corrected visual acuities among the three groups (p = 0.189).
CONCLUSIONS
Importantly, there appears to be a significant correlation between alpha1AB and the development of IFIS. To prevent complications of IFIS, surgeons should be vigilant in identifying patients taking alpha1AB, checking the degree of preoperative pupil dilatation and anticipating intraoperative difficulties. In addition, appropriate modifications should be made to the surgical strategy. Furthermore there was no benefit to discontinuing alpha1AB treatment before cataract surgery in the prevention of IFIS.

Keyword

alpha1-adrenergic blocker; Intraoperative floppy iris syndrome; Phacoemulsification

MeSH Terms

Adrenergic Antagonists
Cataract
Dilatation
Eye
Humans
Incidence
Phacoemulsification
Prospective Studies
Pupil
Visual Acuity
Adrenergic Antagonists

Figure

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  Figure 1 Comparison of absolute phaco time (%·sec) of three groups repective to cataract densities: group A (α1AB takers who stop 1 week before cataract surgery), group B (α1AB takers who did not stop before cataract surgery), group C (no medication users). *p-value obtained by comparison of three groups (A, B, and C) with 1-way ANOVA in mild cataract density group. †p-value obtained by comparison of three groups (A, B, and C) with 1-way ANOVA in moderate cataract density group. ‡p-value obtained by comparison of three groups (A, B, and C) with 1-way ANOVA in severe cataract density group.

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