Ophthalmology department, University Hospital of Nice, 30 Voie Romaine, 06000 Nice, France.
Medical Biology department, University Hospital of Nice, 30 Voie Romaine, 06000 Nice, France.
J Fr Ophtalmol. 2024 Nov;47(9):104293. doi: 10.1016/j.jfo.2024.104293. Epub 2024 Sep 24.
Intraoperative floppy iris syndrome (IFIS) is defined as an excessive billowing of the iris during cataract surgery. Floppy eyelid syndrome is defined as an excessive hyperlaxity of the eyelids. Based in our daily experience, we suspected FES to be associated with IFIS. This association has been investigated. The goal of the study was to explore whether FES was predictive of IFIS.
We conducted a prospective observational single-center study at the University Hospital of Nice. IFIS and FES were investigated in patients undergoing cataract surgery from November 2019 to May 2021. In addition, tarsus and iris samples were harvested in 2 fresh cadavers, and Verhoeff staining was used to identify elastin fibers.
We included 452 eyes (n=312 patients, 50.9% male) with a mean age of 71.7years (±11.4). IFIS was diagnosed in 88 (19.5%) patients, including 20 (4.4%) grade 1, 34 (7.5%) grade 2, and 33 (7.3%) grade 3. FES was diagnosed in 35 (7.7%) patients. PEX was found in 23 (5.1%) patients. On multivariate analysis, FES (P<0.001), pseudo exfoliation (P=0.017), intracameral dilatation (P<0.004), senior surgeons (P=0.009) and α1-ARA (P<0.001) were associated with IFIS. Elastin fibers were identified in small amounts in the tarsus samples but not in the iris samples.
FES is predictive of IFIS. Surgeons should be aware of this association to prevent intraoperative complications.
术中虹膜膨隆综合征（IFIS）定义为白内障手术过程中虹膜过度膨隆。眼睑松弛综合征定义为眼睑过度松弛。根据我们的日常经验，我们怀疑 FES 与 IFIS 有关。已经对这种关联进行了研究。本研究的目的是探讨 FES 是否可预测 IFIS。
我们在尼斯大学医院进行了一项前瞻性观察性单中心研究。在 2019 年 11 月至 2021 年 5 月期间对接受白内障手术的患者进行了 IFIS 和 FES 调查。此外，在 2 例新鲜尸体中采集了睑板和虹膜样本，并使用 Verhoeff 染色来识别弹性纤维。
我们纳入了 452 只眼（n=312 例患者，50.9%为男性），平均年龄为 71.7 岁（±11.4）。88 例（19.5%）患者诊断为 IFIS，其中 20 例（4.4%）为 1 级，34 例（7.5%）为 2 级，33 例（7.3%）为 3 级。35 例（7.7%）患者诊断为 FES。23 例（5.1%）患者发生 PEX。多变量分析显示，FES（P<0.001）、假性剥脱（P=0.017）、房水内扩张（P<0.004）、高级别外科医生（P=0.009）和α1-ARA（P<0.001）与 IFIS 相关。在睑板样本中检测到少量的弹性纤维，但在虹膜样本中未检测到。
FES 可预测 IFIS。外科医生应意识到这种关联，以防止术中并发症。
