白内障超声乳化术中虹膜松弛综合征发生的新危险因素和预测指标  

A study of risk factors and predictive factors in intraoperative floppy iris syndrome during phacoemulsification

作　　者：俞捷心 姚克[2] 

机构地区：[1]浙江中医药大学附属第一医院眼科,中国浙江省杭州市310000 [2]浙江大学医学院附属第二医院眼科,中国浙江省杭州市310009

出　　处：《国际眼科杂志》2017年第11期2126-2129,共4页International Eye Science

摘　　要：目的:观察中国患者虹膜松弛综合征(IFIS)在白内障超声乳化术中的发生率,并探究IFIS的新危险因素及其可能的预测指标。方法:前瞻性、观察性研究。我们收集了1a内进行白内障手术的患者。记录他们的服药史、散瞳前后的瞳孔直径、IFIS发生的情况。结果:有中国汉族的白内障手术患者807例1 068眼,共计1 068例手术纳入研究,其中34眼发生了IFIS。进行回归分析发现,以下危险因素与IFIS的发生有关:非那西丁(6.4%,OR=5.885),坦洛新(25%,OR=21.578),利血平(16.7%,OR=12.947),氯氮平(66.7%,OR=139.467)及全视网膜光凝术后(14.3%,OR=10.789)。散瞳后瞳孔直径小,尤其是小于7.25mm的患者更易于发生IFIS(P<0.001)。结论:中国人群中IFIS的发生率是3.18%。我们发现了3个新的IFIS危险因素:利血平、氯氮平用药史和视网膜光凝术后。术前散瞳困难可能预示着IFIS的发生几率增大。AIM. To determine the incidence of intraoperative floppy iris syndrome { IFIS） in patients undergoing phacoemulsification in a Chinese hospital, and to assess new risk factors and predictive factors for IFIS. METHODS- A prospective, observational case series. In the consecutive cataract surgeries performed in one year, the medicine administration, pupil size （PS） before and after mydriasis, and signs of IFIS were recorded. RESULTS. Totally 807 patients （1068 eyes） underwent cataract surgeries. Among the 1068 eyes, signs of IFIS were noted in 34 eyes. Strong positive correlations were showed between finasteride （6. 4%, OR = 5. 885 ）, tamsulosin （25%, OR=21.578）, reserpine （16.7%, OR= 12. 947）, clozapine （66. 7%, OR= 139. 467）, postpanretinal photocoagulation （14.3%, OR= 10. 789） and IFIS. Pupil size was inversely related to IFIS incidence （P〈0. 001 ）. A dilated pupil smaller than 7.25mm could predict IFIS （ P〈0.001 ）. CONCLUSION. The incidence rate of IFIS was 3.18%. Reserpine, clozapine and post - panretinal photocoagulation emerged as new risk factors for IFIS. A small dilated pupil may imply IFIS occurrence.

关 键 词：虹膜松弛综合征 危险因素 预测因素 并发症 

分 类 号：R779.66[医药卫生—眼科]