Pedut Kloizman Tamar, Shehadeh Mashour Raneen
Bnai-Zion Medical Center.
Harefuah. 2016 Sep;155(9):542-546.
Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell in 2005. The characteristics of this syndrome include: 1. Floppy iris that billows in reaction to intraocular fluid currents during standard phacoemulsification procedure; 2. Flaccid iris stroma that tends to prolapse through well-constructed surgical incisions; 3. Insufficient pupillary mydriasis despite proper pharmacologic preparation and progressive pupillary constriction during the operation. Surgical procedures with IFIS have since been noted to have an exceptionally high rate of complications, some of which can be vision threatening. These complications include: radial tear in the anterior capsule, a posterior capsule rupture with vitreous prolapse, retained lens fragments, anterior chamber hemorrhage, increased postoperative inflammation, permanent damage to the iris causing a deformed pupil, glare and photophobia, cystoid macular edema, retinal detachment and endophthalmitis. Several studies have found substantial aetiological association between IFIS and current or previous consumption of selective α1 adrenoreceptors antagonists. The strongest association was found with the drug Tamsulosin (Flomax). The α1 anatagonists are commonly used to treat lower urinary tract symptoms in elderly men with benign prostatic hyperplasia. This article will review current knowledge about IFIS including historical background, incidence, pharmacological mechanism and possible measures and methods aimed to reduce surgical complications.
术中虹膜松弛综合征（IFIS）于2005年由张和坎贝尔首次描述。该综合征的特征包括：1. 在标准超声乳化手术过程中，虹膜松弛，随眼内液流波动；2. 虹膜基质松弛，易通过精心构建的手术切口脱垂；3. 尽管进行了适当的药物准备，但瞳孔散大不足，且术中瞳孔逐渐缩小。此后发现，患有IFIS的患者进行手术时并发症发生率异常高，其中一些并发症可能威胁视力。这些并发症包括：前囊放射状撕裂、后囊破裂伴玻璃体脱垂、晶状体碎片残留、前房出血、术后炎症加重、虹膜永久性损伤导致瞳孔变形、眩光和畏光、黄斑囊样水肿、视网膜脱离和眼内炎。多项研究发现，IFIS与目前或既往使用选择性α1肾上腺素能受体拮抗剂之间存在显著的病因学关联。与药物坦索罗辛（哈乐）的关联最为密切。α1拮抗剂常用于治疗老年良性前列腺增生男性的下尿路症状。本文将综述关于IFIS的现有知识，包括历史背景、发病率、药理机制以及旨在减少手术并发症的可能措施和方法。
