Flach Allan J
Department of Ophthalmology, University of California, San Francisco (UCSF) Medical Center, USA.
Trans Am Ophthalmol Soc. 2009 Dec;107:234-9.
To extend upon previous reports, observations, and discussions of intraoperative floppy iris syndrome (IFIS) with the goal of providing new insight into the syndrome's pathophysiology, prevention, and treatment.
Following a review of IFIS and its relationship to autonomic pharmacology, evidence for anatomic changes following exposure of humans and other animals to autonomic drugs is described. The clinical implications for these findings are discussed as they relate to the treatment and prevention of this syndrome.
IFIS has been associated with the use of adrenergic antagonists even after they have been discontinued years prior to surgery. Some investigators believe that this persistence of IFIS reflects anatomic structural change. Evidence from laboratory experiments and human clinical studies using topically applied and systemic autonomic drugs supports the possibility of anatomic changes coexisting with IFIS observed during cataract surgery.
IFIS is a relatively rare syndrome, often associated with the use of systemic alpha-blockers and conditions that influence dilator muscle tone. Laboratory and clinical evidence supports the possibility of anatomic changes following the use of autonomic drugs. The persistence of IFIS years after cessation of treatment with alpha-blockers suggests that the potential risks of discontinuing these drugs prior to cataract surgery outweigh potential benefits.
扩展先前关于术中虹膜松弛综合征（IFIS）的报告、观察结果及讨论，旨在为该综合征的病理生理学、预防及治疗提供新见解。
在回顾IFIS及其与自主神经药理学的关系后，描述人类及其他动物接触自主神经药物后解剖学变化的证据。讨论这些发现与该综合征治疗及预防相关的临床意义。
即使在术前数年停用肾上腺素能拮抗剂后，IFIS仍与之相关。一些研究者认为IFIS的这种持续性反映了解剖结构变化。使用局部应用和全身自主神经药物的实验室实验及人体临床研究证据支持白内障手术中观察到的解剖学变化与IFIS并存的可能性。
IFIS是一种相对罕见的综合征，常与全身α受体阻滞剂的使用及影响瞳孔开大肌张力的情况相关。实验室和临床证据支持使用自主神经药物后出现解剖学变化的可能性。在停用α受体阻滞剂多年后IFIS仍持续存在，这表明在白内障手术前停用这些药物的潜在风险超过潜在益处。
