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[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。
[Key word]
[Abstract]
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(1 068 eyes)underwent cataract surgeries. Among the 1 068 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), post-panretinal 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.
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