From the 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
J Cataract Refract Surg. 2022 Nov 1;48(11):1335-1341. doi: 10.1097/j.jcrs.0000000000001017.
Intraoperative floppy-iris syndrome (IFIS) is an increasingly recognized condition that is proven to lead to higher rates of intraoperative complications. This study provides an updated systematic review and meta-analysis regarding all the identified factors predisposing to IFIS. The study was performed in accordance with the PRISMA guidelines. 38 studies were finally included in the meta-analysis. The factors that were found to predispose to IFIS significantly were male sex (odds ratio [OR], 4.25; CI, 2.58-7.01), hypertension (OR, 1.55; CI, 1.01-2.37), tamsulosin (OR, 31.06; CI, 13.74-70.22), finasteride (OR, 4.60; CI, 1.97-10.73), benzodiazepines (OR, 2.88; CI, 1.17-7.12), and antipsychotics intake (OR, 6.91; CI, 2.22-21.50). A decreased dilated pupil preoperatively was found predisposing to IFIS (weighted mean difference -0.93; CI, -1.19 to -0.67). Intracameral epinephrine, which was investigated as a potential prophylactic measure for preventing IFIS, did not reach statistical significance (OR, 0.29; CI, 0.08-1.06). A comprehensive preoperative assessment of all risk factors is vital to stratify the surgical risk, which is crucial in addressing IFIS because unanticipated IFIS could turn a routine surgery into one of significant visual morbidity.
术中虹膜膨隆综合征（IFIS）是一种日益被认识的疾病，已被证实会导致更高的术中并发症发生率。本研究提供了一项关于所有被认为易患 IFIS 的因素的更新的系统评价和荟萃分析。该研究按照 PRISMA 指南进行。最终有 38 项研究纳入荟萃分析。发现易患 IFIS 的显著因素为男性（优势比 [OR]，4.25；95%置信区间 [CI]，2.58-7.01）、高血压（OR，1.55；95%CI，1.01-2.37）、坦索罗辛（OR，31.06；95%CI，13.74-70.22）、非那雄胺（OR，4.60；95%CI，1.97-10.73）、苯二氮䓬类药物（OR，2.88；95%CI，1.17-7.12）和抗精神病药物的摄入（OR，6.91；95%CI，2.22-21.50）。术前瞳孔扩张不良被发现易患 IFIS（加权均数差 -0.93；95%CI，-1.19 至-0.67）。作为预防 IFIS 的潜在预防措施而进行的房内肾上腺素研究没有达到统计学意义（OR，0.29；95%CI，0.08-1.06）。全面评估所有危险因素对于分层手术风险至关重要，这对于处理 IFIS 至关重要，因为意外的 IFIS 可能会使常规手术变成具有显著视力发病率的手术。
