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Study links recent tamsulosin use and complications after cataract surgery
JAMA. 2009;301(19):1991-1996.
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Recent use of tamsulosin to treat benign prostatic hyperplasia in older men was significantly linked with increased risk of serious complications after cataract surgery, while other alpha-blockers were not linked with increased risk, according to a study.
Flomax (tamsulosin, Boehringer Ingelheim) use has been linked to intraoperative floppy iris syndrome, which may complicate cataract surgery. However, data linking tamsulosin or other alpha-blockers to postoperative complications are lacking, the study authors said.
"Because the combination of cataract surgery and tamsulosin exposure is relatively common, patients should be properly apprised of the risks of drug therapy and preoperative systems should focus on the identification of tamsulosin use by patients," they said. "In this way, surgeons can plan and prepare for a potentially more complicated procedure or refer to someone with more experience."
Investigators used the Ontario Health Insurance Plan database to identify 96,128 men age 66 years or older who underwent cataract surgery between April 2002 and June 2007.
They identified 284 patients who had complications within 14 days after surgery and matched 280 of those cases with 1,102 controls according to patient age, surgeon and date of cataract surgery.
Recent tamsulosin or other alpha-blocker exposure was defined as within 14 days before surgery. Previous exposure was defined as 15 days to 365 days before surgery.
Postoperative adverse events were more common among patients with recent tamsulosin exposure (7.5%) than among controls (2.7%); 7.5% of patients and 8% of controls had recent exposure to other alpha-blockers but were not associated with adverse events. Previous exposure to tamsulosin or other alpha-blockers was also not associated with adverse events.
Postop complications included retinal detachment, lost lens or lens fragment, or endophthalmitis. Procedures performed 1 to 14 days after cataract surgery included vitrectomy, vitreous aspiration or injection, dislocated lens extraction or air-fluid exchange.