Intraoperative Floppy Iris Syndrome (IFIS) — a new small pupil syndrome that appears to be associated with the use of Flomax, a systemic alpha-1 antagonist medication. This drug relaxes the smooth muscle in the bladder neck and prostate, improving urinary flow in patients with symptomatic benign prostatic hypertrophy (BPH). same alpha-1A receptor subtype is also present in the iris dilator smooth muscle.

“We postulate that prolonged pharmacologic blockade results in loss of normal iris dilator smooth muscle tone. This deficient tone produces the floppy iris behavior caused by normal intraocular fluid currents during surgery,”

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