2025 ICD-10-CM code H21.81
(Active) Effective Date: N/A Diseases of the eye and adnexa - Disorders of sclera, cornea, iris and ciliary body 7 Feed
Floppy iris syndrome (IFIS). This condition is often associated with the use of alpha-1 antagonist medications.
Medical necessity for procedures related to IFIS is established by the presence of the condition during cataract surgery and the need for interventions to manage it and ensure a safe and successful surgical outcome. This often necessitates the use of additional resources and specialized techniques.
Diagnosis and management of IFIS falls under the purview of ophthalmologists.They are responsible for recognizing the condition, taking appropriate precautions during surgery, and managing any related complications.
In simple words: Floppy Iris Syndrome (IFIS) is a problem that can happen during cataract surgery, especially in men who take certain prostate medications.The iris (the colored part of the eye) becomes floppy and difficult to control, which can make the surgery more complicated.
Intraoperative floppy iris syndrome (IFIS) is a complication that can occur during cataract surgery, primarily in patients who have taken alpha-1 antagonist medications, such as tamsulosin, for conditions like benign prostatic hyperplasia. It is characterized by a triad of symptoms: poor pupillary dilation, a flaccid or billowing iris, and a tendency for the iris to prolapse through surgical incisions.This can make cataract surgery more challenging and increase the risk of complications.
Example 1: A 65-year-old male with a history of benign prostatic hyperplasia and taking tamsulosin presents for cataract surgery. During the procedure, the ophthalmologist observes the characteristic signs of IFIS: a poorly dilating pupil, billowing iris, and prolapse of the iris through the surgical incision.The surgeon uses techniques like iris hooks or a capsular tension ring to manage the IFIS and complete the surgery., A 70-year-old male patient on terazosin is scheduled for cataract surgery. Knowing the risk of IFIS, the ophthalmologist discusses the potential complications with the patient and plans the surgery accordingly, considering the use of specialized devices and techniques., A 75-year-old female, not on any alpha-1 antagonists, unexpectedly exhibits intraoperative signs consistent with IFIS during cataract extraction.The surgeon adjusts the surgical approach to manage the unexpected iris behavior and minimize potential complications.
Documentation for IFIS should include a detailed history of medications, specifically noting any alpha-1 antagonist use. Intraoperative findings, such as poor pupillary dilation, iris prolapse, and the use of any special techniques or devices (e.g., iris hooks, capsular tension ring) to manage the IFIS, must be clearly documented.
** While tamsulosin is the most commonly associated medication with IFIS, other alpha-1 antagonists can also contribute to the condition. It is essential to inquire about all medications the patient is taking before cataract surgery.
- Payment Status: Active
- Specialties:Ophthalmology
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, On Campus-Outpatient Hospital