Groups issue advisory about alpha-blockers and cataract surgery complications

AUA, the American Society of Cataract and Refractive Surgery, and the American Academy of Ophthalmology have advised patients taking alpha-blockers for BPH treatment to inform their eye surgeon about the drugs before undergoing eye surgery. These drugs can potentially cause complications during cataract surgery; however, preliminary results of a new study found that these patients can still have successful surgery if their surgeon knows they are taking these drugs and alters the surgical technique.

Current alpha-blockers include tamsulosin (Flomax), alfuzosin (Uroxatral), terazosin (Hytrin), and doxazosin (Cardura).

In 2005, David F. Chang, MD, and John R. Campbell, MD, completed both a retrospective and prospective study of 1,600 patients using tamsulosin and undergoing cataract surgery to identify a problem they identified as intraoperative floppy iris syndrome.

“Flomax does not affect vision or eye health. But it impairs the dilator muscle in the iris, and during cataract surgery the pupil needs to stay dilated,” Dr. Chang said.

To assess the effectiveness of the modifications to the techniques, Dr. Chang and colleagues conducted a more recent trial at 10 centers around the country. The study of more than 160 cataract surgeries demonstrated that if the surgeon knew about tamsulosin use in advance, and if the modified surgical techniques were used, the surgical success rate was excellent and the complication rate was not increased in comparison to surgery on patients who were not taking tamsulosin.

Look for a more detailed article in the Oct. 1 issue of Urology Times.