Optical biometric parameters associated with intraoperative floppy iris syndrome: a retrospective analysis

Background To compare ocular biometric measurements between the general population and individuals who developed intraoperative floppy iris syndrome (IFIS) during cataract surgery.Methods SRetrospective cohort analysis of patients who underwent phacoemulsification cataract surgery in one tertiary medical center. Biometric data was collected using the IOLMaster700 in a pre-operative evaluation. Participants who underwent cataract surgery were categorized into two groups: individuals who developed IFIS and individuals who did not develop IFIS. The biometric parameters were then analyzed and compared between the two groups.Results A total of 7,386 cataract surgeries were evaluated. Approximately 3% (n = 226) of eyes experienced IFIS. Pupil diameter was significantly smaller in patients with IFIS compared to those without IFIS in our study cohort (p < 0.001). In addition, lens thickness was notably larger (p < 0.001), anterior chamber depth (ACD) and aqueous depth p were shallower (p < 0.01) in the IFIS group. Patients with IFIS in the first eye demonstrated an increased risk for IFIS in the fellow eye (p < 0.01). Following subgroup analysis, we that patients with pupil diameter < 2.4 mm, ACD < 2.9 mm, and lens thickness > 4.6 mm had a 21% incidence of IFIS.Conclusions Our study provides insights into anatomic risk factors associated with IFIS. Correlations identified between biometric measurements and IFIS risk contribute to a comprehensive risk stratification. These findings may guide surgeons in risk assessment and proactive measures before cataract surgeries, especially in individuals with a history of IFIS. It is important to note that this study aims solely to identify potential correlations between biometric parameters and the occurrence of IFIS.