Intraoperative floppy-iris syndrome: Do we know everything about it?

We report a case of bilateral phacoemulsification for nuclear cataract in a 76-year-old man. The patient took tamsulosin for 4 months and stopped the medication 1 year before the cataract surgery. Phacoemulsification in the left eye was uneventful. One week later, phacoemulsification was performed in the same manner in the right eye, which demonstrated the 3 signs of the intraoperative floppy-iris syndrome (IFIS). Postoperative examinations revealed iris stromal atrophy and an irregular pupil in this eye. This case raises many questions: Why was IFIS seen in 1 eye only? Is the intake and stopping time of tamsulosin important to the occurrence of IFIS? Is intracameral adrenaline effective in preventing IFIS? Future studies are needed to increase our understanding of IFIS.