As surgeons we must remember (and teach our patients) that the results of surgery are a combination of our surgical technique and the patient’s anatomy and healing. Our guest surgeon is an expert who has done thousands of cataract surgeries and frequently deals with floppy iris syndrome (IFIS) from Flomax (tamsulosin) use. This case is stressful for any surgeon and watching the video reminds me of similarly tough surgeries that I have dealt with in the past. What would be your approach when the IFIS gets ugly?
I think stretching a pupil that is prone to floppy iris syndrome is a recipe for disaster. I also don’t understand why you would want to try to be the hero that doesn’t use the aids that we have now to prevent all this problem. Put in a ring put in hooks do something don’t just let it get worse and worse.
My biggest disasters are when I think I’ve got a pupil that I can get by with on size. My scrub tech has been instructed to remind me whenever I’m debating about whether to put a ring in or not that I should put a ring in so everyone can go home on time.