抗前列腺增生药物与虹膜松弛症的相关分析

Relationship between benign prostatic hyperplasia medications and intraoperative floppy-iris syndrome

目的评估抗前列腺增生药物,α1肾上腺素能受体拮抗剂坦洛新,5α-还原酶抑制剂非那雄胺,与白内障超声乳化术中发生虹膜松驰症(IFIS)的关系。方法回顾性分析2014年1月至2015年12月,在我院施行白内障超声乳化手术患者402例(439只眼),男性211例(235只眼),女性191例(204只眼),年龄55~94岁,平均78.23岁,筛选有良性前列腺增生(BPH)史患者180例(190只眼),根据服用抗BPH药物的情况分成A、B两组,各50只眼,A组单纯服用盐酸坦洛新,B组单纯服用非那雄胺,观察A、B两组发生IFIS的概率及术后并发症。结果A、B两组均有患者发生了IFIS,A组发生6只眼,B组发生3只眼,χ~2=0.49,A、B两组比较,P>0.05,差异无显著性。术后出现的并发症:一过性高眼压4只眼,角膜水肿2只眼,1只眼术中使用虹膜拉钩,术后出现瞳孔变形。结论白内障超声乳化术中出现的IFIS可能与抗BPH药物有关,肾上腺素能α1受体拮抗剂与5α-还原酶抑制剂均可引起。

Objective To assess the relationship between intraoperative floppy-iris syndrome（ IFIS） occurred in phacoemulsification and anti BPH drugs-adrenergic α1 receptor antagonist tamsulosin and 5α-reductase inhibitor finasteride. Methods A retrospective review of cataract surgeries performed in the author＇s hospital from January 2014 to December 2015（ 402 patients,n=439 eyes）. Among these patients,211 were male（ n=235 eyes）,and 191 were female（ n=204 eyes）. Age was between 55～94 years（ average 78.23）. There were 180 patients with BPH history（ n=190eyes）. According to the types of BPH drugs these patients took,they were divided into group A（ tamsulosin hydrochloride）and group B（ finasteride）,each 50 eyes. We observed the probability of IFIS in the two groups. Results Both groups had IFIS cases but there was no significant in incidence（ χ^2=0.49,P=0.485）. Complications induced transient high intraocular pressure in 4 eyes,corneal edema in 2 eyes,and postoperative pupil deformation in 1 eye（ used iris retractors during surgery）. Conclusions IFIS during phacoemulsification may be correlated with BPH medications such as adrenergic α1 receptor antagonist and finasteride.