Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, , Seoul, South Korea.
Br J Ophthalmol. 2014 Apr;98(4):479-83. doi: 10.1136/bjophthalmol-2013-304135. Epub 2014 Jan 23.
To evaluate the incidence and clinical manifestations of intraoperative floppy iris syndrome (IFIS) according to iris alterations in Korean patients taking α1-adrenergic receptor antagonists (α1-ARAs).
This is a prospective observational study. Two surgeons performed cataract surgery in 758 eyes of 596 patients over a period of 12 months. Past medical history was reviewed, especially whether patients had been taking systemic α1-ARAs. Ultrasound biomicroscopy was performed to measure the iris thickness of the dilator muscle region (DMR) at half the distance between the scleral spur and the pupillary margin. Pupil diameter was measured and the occurrence of IFIS was recorded. Measurements of the α1-ARA group were compared with those of a control group matched for age and sex.
IFIS occurred only in six eyes of four patients on systemic α1-ARA medications (0.8%). Pupil diameter in the α1-ARA medication group and the control group was not significantly different. The difference in mean DMR thickness in patients taking an α1-ARA and in the control group was also not statistically significant (p=0.641). However, within the α1-ARA population, the DMR thickness of IFIS cases was significantly lower than that of non-IFIS cases (p=0.013) CONCLUSIONS: The overall incidence of IFIS was far lower in Korean patients than that reported for western patients. IFIS patients taking α1-ARAs showed significantly greater iris DMR thinning than non-IFIS patients taking α1-ARAs. Our findings indicate that the interaction between α1-ARAs and melanin, which results in iris DMR atrophy and IFIS, is less strong in Korean patients (with dark irises) than western patients.
根据服用α1-肾上腺素能受体拮抗剂（α1-ARAs）的韩国患者的虹膜改变，评估术中虹膜膨隆综合征（IFIS）的发生率和临床表现。
这是一项前瞻性观察研究。两名外科医生在 12 个月的时间内对 596 名患者的 758 只眼进行了白内障手术。回顾了既往病史，特别是患者是否服用过全身α1-ARAs。使用超声生物显微镜测量巩膜突与瞳孔缘之间一半距离处的扩瞳肌区（DMR）的虹膜厚度。测量瞳孔直径并记录 IFIS 的发生情况。将α1-ARA 组的测量值与年龄和性别相匹配的对照组进行比较。
仅在四名服用全身α1-ARA 药物的患者的六只眼中发生 IFIS（0.8%）。α1-ARA 药物组和对照组的瞳孔直径无显著差异。服用α1-ARA 药物的患者与对照组的平均 DMR 厚度差异也无统计学意义（p=0.641）。然而，在α1-ARA 人群中，IFIS 病例的 DMR 厚度明显低于非 IFIS 病例（p=0.013）。
韩国患者的 IFIS 总体发生率远低于西方患者。服用α1-ARAs 的 IFIS 患者的虹膜 DMR 变薄明显大于未服用α1-ARAs 的 IFIS 患者。我们的研究结果表明，α1-ARAs 与黑色素之间的相互作用导致虹膜 DMR 萎缩和 IFIS，在韩国患者（虹膜颜色较深）中的作用弱于西方患者。
