Department of Ophthalmology, School of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey.
J Ocul Pharmacol Ther. 2013 May;29(4):410-3. doi: 10.1089/jop.2012.0151. Epub 2012 Dec 5.
To evaluate structural alterations of iris and pupil diameters (PDs) in patients using systemic α-1-adrenergic receptor antagonists (α-1ARAs), which are associated with intraoperative floppy iris syndrome (IFIS).
Eighty-eight eyes of 49 male were evaluated prospectively. Patients were assigned to 2 different groups. Study group included 23 patients taking any systemic α-1ARAs treatment, and control group included 26 patients not taking any systemic α-1ARAs treatment. All patients underwent anterior segment optical coherence tomography to evaluate iris thickness at the dilator muscle region (DMR) and at the sphincter muscle region (SMR). The PD was measured using a computerized infrared pupillometer under scotopic and photopic illumination.
The study group included 46 eyes of 23 patients and the control group included 42 eyes of 26 patients. Most treated patients were on tamsulosin (16/23). Mean age was similar in the study and control groups (61.9±7.1 vs. 60.3±8, 2 years, nonsignificant). DMR (506.5±89.4 vs. 503.6±83.5 μm), SMR (507.8±78.1 vs. 522.1±96.4 μm) and the DMR/SMR ratio (1.0±0.15 vs. 0.99±0.23 μm) was similar in the study and control groups and these differences were nonsignificant. Scotopic PDs were also similar in both groups (3.99±1.11 vs. 3.74±1.35, nonsignificant). A significantly reduced photopic PD (2.89±0.55 vs. 3.62±0.64, P<0.001) and an increased scotopic/photopic PD (1.42±0.44 vs. 1.02±0.30, P<0.001) were found in the study group.
Evaluating PD alterations might be more useful than evaluating iris structural alterations in predicting IFIS. There is still a need for a reliable method that will determine the possibility of IFIS.
评估使用全身 α-1 肾上腺素能受体拮抗剂（α-1ARAs）的患者的虹膜和瞳孔直径（PD）的结构变化，这些变化与术中软性虹膜综合征（IFIS）有关。
前瞻性评估了 49 名男性的 88 只眼。患者被分为 2 个不同的组。研究组包括 23 名接受任何全身 α-1ARAs 治疗的患者，对照组包括 26 名未接受任何全身 α-1ARAs 治疗的患者。所有患者均接受眼前节光学相干断层扫描（OCT）以评估瞳孔开大肌区（DMR）和瞳孔括约肌区（SMR）的虹膜厚度。PD 是在暗适应和明适应下使用计算机化的红外瞳孔计测量的。
研究组包括 23 名患者的 46 只眼，对照组包括 26 名患者的 42 只眼。大多数接受治疗的患者服用坦索罗辛（16/23）。研究组和对照组的平均年龄相似（61.9±7.1 岁与 60.3±8 岁，无显著性差异）。DMR（506.5±89.4μm 与 503.6±83.5μm）、SMR（507.8±78.1μm 与 522.1±96.4μm）和 DMR/SMR 比值（1.0±0.15μm 与 0.99±0.23μm）在研究组和对照组之间相似，这些差异无显著性。两组的暗适应 PD 也相似（3.99±1.11μm 与 3.74±1.35μm，无显著性差异）。研究组发现明适应 PD 明显降低（2.89±0.55μm 与 3.62±0.64μm，P<0.001），暗适应/明适应 PD 增加（1.42±0.44μm 与 1.02±0.30μm，P<0.001）。
评估 PD 变化可能比评估虹膜结构变化更有助于预测 IFIS。仍然需要一种可靠的方法来确定 IFIS 的可能性。
