摘要
目的研究虹膜松弛综合征(IFIS)的发病机制、临床表现及应对措施。方法统计白内障手术患者348例(400眼),其中行白内障超声乳化术(PHACO)及白内障囊外摘出术(ECCE)各200眼,分析IFIS的发生与手术方式及服用α-1受体拮抗剂坦洛新等一些因素的相关性;并对最近出现IFIS的3例白内障患者,术中前房注射苯肾上腺素,观察虹膜反应。结果348例患者中有12例(3.4%)服用过坦洛新,其中7例(2.0%)术中发生IFIS;口服坦洛新的患者IFIS的发病率,在ECCE组为85.7%,在PHACO组为25%,两者比较差异有统计学意义(P<0.05)。3例IFIS患者前房注射苯肾上腺素后,瞳孔变大或虹膜脱出症状减轻。结论白内障术中IFIS的发病可能与坦洛新有关;ECCE组较PHACO组IFIS的发病率高;苯肾上腺素术中使用可部分对抗IFIS的发病。
Objective This study tried to investigate the possible causative factors ,clinical manifestations and therapeutic strategy of intraoperative floppy iris syndrome（ IFIS）. Methods Review of consecutive cataract surgeries including 400 eyes of 348 patients was performed in Zhejiang Taizhou Central Hospital. The operative fashions of these consecutive eyes included extracapsular cataract extraction（ ECCE ） （ 200 eyes ） and phacoemulsification （ PHACO ） （ 200 eyes ）. The relationship of the clinical findings of IFIS and two kinds of surgeries, systemic sympathetic α-1 antagonist medications and other factors were assessed. Results Tamsulosin,a medication of sympathetic α-1 antagonist,was orally administered in 12/348 patients,and 7 of them occurred intraoperative IFIS. The overall incidence of IFIS was 7/348 （ 2.0% ）. In the 12 patients who administered tamsulosin ,IFIS was noted in 6/7 of ECCE patients and 2/8 of PHACO patients ,showing a significant difference between them（ P 〈 0. 05 ）. In the 3 IFIS patients with anterior chamber phenylephrine injection,the contraction of pupils or the prolapse of iris got improvement. Conclusion IFIS occur in approximately 2% of cataract surgery population in our study and appear to be related to the utilization of tamsulosin. The incidence of IFIS in the population of applying tamsulosin is higher in ECCE group than in PHACO group. The application of phenylephrine in anterior chamber can partly relieve the symptom of IFIS.
出处
《眼科研究》
CSCD
北大核心
2008年第6期470-472,共3页
Chinese Ophthalmic Research
关键词
虹膜松弛综合征
白内障囊外摘出术
白内障超声乳化术
α-1受体拮抗剂
intraoperative floppy iris syndrome
extracapsular cataract extraction
phacoemulsification
sympathetic α-1 antagonist
