Department of Ophthalmology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic.
Department of Ophthalmology, University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023 Mar;167(1):9-15. doi: 10.5507/bp.2022.042. Epub 2022 Oct 4.
Intraoperative floppy iris syndrome (IFIS) is a cataract surgery complication that remains a challenge for eye surgeons. It is caused by the antagonism of alfa-1-adrenergic receptors within the dilator muscle of the iris, thus preventing the iris from dilation during a cataract surgery. The long-term blocking alfa-1 adrenergic receptors by the chronic use of a number of systemic medications may lead to permanent anatomical atrophy of the dilator muscle of the iris. The most common drugs associated with the development of IFIS are tamsulosin and other alpha-1 adrenergic receptor antagonists prescribed to patients with low urinary tract symptoms (LUTS). There are other systemic medications that have been reported to have increased risk for IFIS. It is crucial for the ophthalmologist to identify the high-risk patients prone to develop IFIS. Its presence may complicate the course of cataract surgery, ultimately negatively affecting visual outcome. Cataract surgery should be performed by an experienced eye surgeon using alternative pharmacological and surgical techniques. Interdisciplinary cooperation is essential to mitigate potential complications. Patients should be informed by their physicians about the need to report a medication history to their eye specialists, especially before cataract surgery.
术中虹膜膨隆综合征（IFIS）是一种白内障手术的并发症，仍然是眼科医生面临的挑战。它是由虹膜开大肌内的阿尔法-1 肾上腺素能受体的拮抗作用引起的，从而阻止了在白内障手术过程中虹膜的扩张。长期使用许多全身性药物阻断阿尔法-1 肾上腺素能受体可能导致虹膜开大肌的永久性解剖萎缩。与 IFIS 发展最相关的常见药物是坦索罗辛和其他用于治疗下尿路症状（LUTS）的阿尔法-1 肾上腺素能受体拮抗剂。还有其他一些全身性药物也被报道会增加 IFIS 的风险。眼科医生识别易发生 IFIS 的高危患者至关重要。它的存在可能会使白内障手术的过程复杂化，最终对视力结果产生负面影响。白内障手术应由经验丰富的眼科医生使用替代药理学和手术技术来进行。跨学科合作对于减轻潜在的并发症至关重要。医生应告知患者，他们需要向眼科专家报告药物史，尤其是在白内障手术之前。
