Purpose: To determine the incidence of Intraoperative floppy iris syndrome (IFIS) in phacoemulsification surgery in our department, to evaluate the clinical properties and the surgical interventions in these cases.

Materials and Methods: In this prospective study, 1567 eyes of 1530 patients who underwent phacoemulsification surgery and intraocular lens implantation between March 2006-November 2007 were evaluated. Patients were grouped as recent tamsulosin users (Group 1), previous tamsulosin users (Group 2), users of other a₁-antagonists (Group 3), patients never used any kind of a₁-antagonists (Group 4).

Results: IFIS was examined in 25 eyes of 25 patients. Incidence of IFIS was found as 1.6% (25/1530) . IFIS was seen in 80% of patients in Group 1, 60% of Group 2, 1.18% of Group 4. All 6 patients in Group 3 had uneventful cataract surgery and IFIS was not seen in any. Incidence of IFIS in both recent and previous tamsulosin users were significantly higher compared to non tamsulosin users (p<0.001). There was no significant difference in IFIS incidence when tamsulosin was recently or previously used (p=1.000). Surgery was completed without any complications in 72% of eyes with IFIS.

Discussion: Every patient undergoing cataract extraction should be questioned about benign prostate hypertrophy medications- especially tamsulosin, and IFIS propability should be considered in cases with poor preoperative mydriasis. Necessary preventions should be taken before the surgery in these cases and more experienced surgeons should complete the surgery when necessary.