α-1受体拮抗剂患者瞳孔直径与Phaco术中虹膜松弛综合征的关系

发布时间：2018-01-23 21:58

本文关键词： 肾上腺素α-受体拮抗剂瞳孔直径虹膜松驰综合征白内障超声乳化术　出处：《眼科新进展》2014年02期 　论文类型：期刊论文

【摘要】：目的测量服用肾上腺素α-1受体拮抗剂白内障患者在散瞳前后的瞳孔直径,分析其与白内障超声乳化术中虹膜松弛综合征(intraoperative floppy iris syndrome,IFIS)的关系。方法收集3组白内障患者,服用坦索洛辛者(A组)45例(51眼),服用其他α-1受体拮抗剂者(B组)42例(50眼),对照组为无服用α-1受体拮抗剂药物患者(C组)40例(40眼)。散瞳剂为复方托吡卡胺滴眼液。于裂隙灯显微镜下观察用Rosebaum瞳孔测量尺测量散瞳前后术眼瞳孔直径,均施行白内障超声乳化手术治疗,术中记录IFIS的评分。结果 A组散瞳前瞳孔直径为(2.37±0.42)mm,散瞳后直径为(5.43±1.72)mm,IFIS评分为(0.53±0.14)分,组内发生IFIS者散瞳后直径(D)与IFIS得分(S)之间的线性回归方程为S=4.54-0.76 D(P0.01)。B组散瞳前瞳孔直径为(2.40±0.31)mm,散瞳后直径为(5.86±1.13)mm,IFIS评分为(0.21±0.09)分,组内发生IFIS者散瞳后直径与IFIS得分之间线性回归关系不具有相关性(P0.05)。C组散瞳前瞳孔直径为(2.42±0.27)mm,散瞳后直径为(6.47±1.03)mm,IFIS评分为0分。3组间散瞳后瞳孔直径存在显著性差异(P0.01),三组间IFIS得分有显著性差异(P0.01)。结论服用坦索洛辛等α-1受体拮抗剂的患者散瞳后直径减小,可能导致IFIS发生;服用坦索洛辛患者散瞳后瞳孔直径越小,IFIS的程度越严重。
[Abstract]:Objective to measure the pupil diameter before and after mydriasis in patients with epinephrine 伪 -1 receptor antagonist cataract. To analyze the relationship between intraoperative floppy iris syndrome and iridorelaxation syndrome during phacoemulsification. Methods the relationship of IFIS.Methods three groups of cataract patients were collected, 45 cases (51 eyes) of group A were treated with tamsulosin and 42 cases (50 eyes) of group B were treated with other 伪 -1 receptor antagonists. Control group: 40 eyes of 40 patients without 伪 -1 receptor antagonist). The pupil diameter before and after mydriasis was measured with Rosebaum pupillary ruler under slit lamp microscope. Results the pupil diameter before pupil dilation in group A was 2.37 卤0.42 mm. The mean diameter after mydriasis was 5.43 卤1.72 mm and the IFIS score was 0.53 卤0.14). The linear regression equation between the diameter after pupil dilation (D) and the score of IFIS (S) in patients with IFIS in group B was (4. 54-0. 76 DX P 0. 01). The diameter of pupil before pupil dilation in group B was (4. 54-0. 76 DX) (P < 0. 01). 2.40 卤0.31 mm. After mydriasis, the diameter was 5.86 卤1.13mm and the IFIS score was 0.21 卤0.09. There was no correlation between the diameter of pupil after mydriasis and the IFIS score in group C (P 0.05). The pupil diameter before pupil dilation in group C was 2.42 卤0.27 mm. The diameter of pupil after pupil dilation was 6.47 卤1.03mm and IFIS score was 0. 3. There was significant difference in pupil diameter after pupil dilation (P 0.01). There was a significant difference in IFIS scores among the three groups (P 0.01). Conclusion the diameter of patients who take 伪 -1 receptor antagonists such as tansoloxine decreases after pupil dilation, which may lead to the occurrence of IFIS. The smaller the pupil diameter, the more severe the IFIS was in patients taking tamoloxine.
【作者单位】：安徽医科大学附属省立医院眼科;
【分类号】：R779.66;R773.1
【正文快照】： 虹膜松弛综合征(intraoperative floppy iris syn-drome,IFIS)是由Chang等[1]于2005年首次报道,服用坦索洛辛的患者在白内障超声乳化吸出术时可能发生的三联征:松软的虹膜基质随正常的灌注流量而起伏、涌动;虹膜易突出并嵌顿于水密的切口;虽经术前充分的药物散瞳仍出现的术中

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