Tamsulosin and Complications of Cataract Surgery

Tamsulosin (Flomax) is a strongly selective α_1a-blocker that relaxes smooth muscle in the prostate and bladder neck. Because it also relaxes iris muscle, tamsulosin can lead to intraoperative floppy iris syndrome (IFIS) and add to the difficulty of cataract surgery. To investigate whether tamsulosin also elevates risk for adverse events after cataract surgery, Canadian investigators conducted a retrospective, population-based, case-control study using Ontario administrative data.

Of 96,000 men (age, ≥66) who underwent cataract surgery, 284 (0.3%) experienced one or more complications of cataract surgery within 14 days (lost lens or lens fragment, retinal detachment, or endophthalmitis). Case patients were matched to 1102 controls without complications by age, year of surgery, and surgeon. Patients with complications were significantly more likely to have used tamsulosin during the 14 days before surgery than were patients without complications (7.5% vs. 2.7%; adjusted odds ratio, 2.3). Tamsulosin use prior to the 14 days before surgery was not associated with elevated risk, nor was use of other α-blockers (e.g., terazosin, doxazosin).