Intraoperative floppy iris syndrome is a well-known and highly feared entity. By some measures, it is the most common difficulty encountered during cataract surgery and a significant risk factor for severe intraoperative complications, including posterior capsule rupture, zonular dialysis and endophthalmitis.
Typically, intraoperative floppy iris syndrome (IFIS) is associated with prior Flomax (tamsulosin, Boehringer Ingelheim) use. Recently, however, we have come to appreciate another association that appears to be at least as strong, namely, prior Descemet’s membrane endothelial
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