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Iris Prolapse

Background

The iris is a thin, colored diaphragm that is situated anterior to the lens. Although the root of the iris is attached to the ciliary body, the rest of the iris is unsupported. In the event of a corneal wound, the iris tends to prolapse out. Iris prolapse occurs when the iris tissue is observed outside of the wound; iris incarceration occurs when the iris tissue reaches the wound without prolapsing outside the eye.

Iris prolapse may also occur as part of a condition called intraoperative floppy iris syndrome (IFIS) during cataract surgery or trabeculectomy.
This condition is associated with the use of several systemic alpha 1-adrenergic antagonists, such as tamsulosin (Flomax), as was first described by Chang et al in 2005 in patients undergoing cataract surgery. Intraoperative floppy iris syndrome is characterized by poor preoperative pupil dilation and intraoperative iris billowing, iris prolapse, and progressive pupillary miosis.

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