Síndrome de iris fláccido por tamsulosina: Estudio prospectivo frente a grupo control

Bidaguren, A.; Irigoyen, Cristina; Mendicute, Javier; Gutiérrez, E.; Gibelalde, A.; Úbeda, M.

doi:10.4321/s0365-66912007000600006

Cited by 6 publications

(7 citation statements)

References 10 publications

(14 reference statements)

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“…We found significantly less preoperative dilation in the tamsulosin-treated group, and the change in dynamic pupil area from the start of the operation to the end was also significantly greater. This was also reported by Bidaguren et al (2007).…”

Section: Discussionsupporting

confidence: 82%

“…We observed that patients on tamsulosin suffered a 12% decrease in central corneal endothelial cells compared with a 3% decrease in control subjects. A previous study by Bidaguren et al (2007) reported a loss of endothelial cells of 24% in a tamsulosin-treated group of male patients compared with a cell loss of 13% in the control group 1 month after cataract surgery. However, this difference in endothelial cell loss did not reach statistical significance.…”

Section: Discussionmentioning

confidence: 86%

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Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1_aantagonist medication (tamsulosin)

Storr‐Paulsen¹,

Jørgensen²,

Nørregaard³

et al. 2013

Acta Ophthalmologica

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. Purpose: The purpose of this study was to assess the incidence of intraoperative floppy iris syndrome (IFIS) and the morphology of the corneal endothelium after cataract extraction in Caucasian male patients exposed to the α‐1a adrenergic receptor antagonist tamsulosin. Methods: In a clinical prospective study, 23 male patients (23 eyes) treated with tamsulosin due to benign prostatic hyperplasia and 25 male patients (25 eyes) with no tamsulosin treatment had cataract surgery. The divide‐and‐conquer technique was used with the Infinity OZil® machine. A combination of Healon and Healon5 was used in all patients, but the use of additional Vision Blue, iris retractors or intracameral phenylephrine in the tamsulosin group was at the discretion of the surgeon. The endothelial cell density, variation in endothelial cell size (CV), percentage of hexagonal cells and central corneal thickness (CCT) were recorded at baseline and at 3 months postoperatively. Results: In the tamsulosin‐treated group, 19 of 23 eyes (83%) developed IFIS, compared with no IFIS in the control group. Compared with the control group, the tamsulosin group showed significantly less dilatation at the start of the operation, significant miosis during surgery and significantly greater corneal endothelial cell loss 3 months postoperatively (12% versus 3%; p < 0.001). Conclusion: Intraoperative floppy iris syndrome during cataract surgery is significantly associated with tamsulosin‐treated male patients. Patients on tamsulosin showed less preoperative dilatation, significant miosis during surgery, and had significantly greater postoperative endothelial cell loss compared with nontreated patients despite recommended precautions.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 86%

Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1_aantagonist medication (tamsulosin)

Storr‐Paulsen¹,

Jørgensen²,

Nørregaard³

et al. 2013

Acta Ophthalmologica

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“…Along these lines, patients who are taking tamsulosin could encounter a risk of IFIS during cataract medical procedures. [ 4 24 25 ] The chronic use of tamsulosin promotes atrophy of the macular plate and subsequent pupil expansion; this could explain the ﬂaccid nature of this tissue discovered during cataract medical procedures. [ 26 ] Pärssinen et al .…”

Section: Resultsmentioning

confidence: 99%

Intraoperative floppy iris syndrome induced by tamsulosin: The risk and preventive strategies

Tobaiqy

Aalam

Banji

et al. 2021

Middle East Afr J Ophthalmol

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Tamsulosin is an antagonist of a subtype-specific alpha-1A- and alpha-1D-adrenoceptor (AR) that is expressed in the prostate gland, urethra, and bladder. Several reports have shown a possible relationship between ophthalmologic adverse effects and the use of alpha-1-receptor medicines, including tamsulosin. This descriptive review evaluates the intraoperative floppy iris syndrome (IFIS) associated with tamsulosin. A search of the Medline and PubMed databases was conducted to identify control trials, case reports, and observational examinations published in English. The publication dates were restricted (January 1, 2000, to January 1, 2020). Keywords (tamsulosin, alpha-blocker, ocular, eye, adverse reaction, and IFIS) were used in the searches. The searches identified 66 studies including in vitro or in vivo studies, trials, and observational studies. Twenty-two (33.33%) studies were articles citing tamsulosin and IFIS as having confirmed potential risk to ocular safety. The results of this review, including a comprehensive summary of published research on tamsulosin use in different populations, have identified several articles showing associations between tamsulosin and IFIS that merit further investigation. Suspending of potential causative pharmacological treatment of IFIS before ocular surgery including tamsulosin, proper identification of at-risk patients, preoperative prophylaxis treatments, and surgical technique modifications clearly can mitigate the anticipated risk of IFIS induced by tamsulosin.

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“…In the retrospective study comparing the risk of IFIS between patients taking tamsulosin versus alfuzosin based on medical charts, major complications were observed in 15% of the patients with IFIS and included iris laceration, focal iris stromal atrophy, iris dialysis, iris hemorrhage, posterior capsular tear with vitreous loss, zonular dehiscence, transient postoperative hypertension, major iris trauma, and postoperative cystoid macular edema [21]. A prospective study detected higher tendency towards post-operative miosis in patients under treatment with tamsulosin than in the patients in the control group [29]. …”

mentioning

confidence: 99%

“…All patients underwent cataract surgery and were observed for IFIS features. IFIS did not occur in the control group; however, in the tamsulosin group, 67% of patients had one or more signs of IFIS [29]. …”

mentioning

confidence: 99%

Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

Teper¹,

Dobrowolski²,

Wylęgała³

2011

cejurol2/2011

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The prevalence of benign prostate hyperplasia (BPH) and cataract increases with age. Both diseases may develop concomitantly and may affect almost 50% of elderly men as comorbidities. Cataract is treated surgically and it has been reported that there may be an association between use of alpha-blockers for BPH, particularly alpha1A-adrenergic receptor selective drugs, and complications of cataract surgery known as Intraoperative Floppy Iris Syndrome (IFIS). The article reviews literature published on this topic and provides recommendations on how to reduce incidence of iatrogenic IFIS or its severity and outcomes in patients with BPH.

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Síndrome de iris fláccido por tamsulosina: Estudio prospectivo frente a grupo control

Abstract: Intraoperative floppy-iris syndrome occurred in 67% of the patients treated with tamsulosin. The only postoperative secondary effect was a lower pupil reactivity in patients taking tamsulosin.

Cited by 6 publications

References 10 publications

Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1_aantagonist medication (tamsulosin)

Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1_aantagonist medication (tamsulosin)

Intraoperative floppy iris syndrome induced by tamsulosin: The risk and preventive strategies

Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

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Síndrome de iris fláccido por tamsulosina: Estudio prospectivo frente a grupo control

Abstract: Intraoperative floppy-iris syndrome occurred in 67% of the patients treated with tamsulosin. The only postoperative secondary effect was a lower pupil reactivity in patients taking tamsulosin.

Cited by 6 publications

References 10 publications

Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1aantagonist medication (tamsulosin)

Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1aantagonist medication (tamsulosin)

Intraoperative floppy iris syndrome induced by tamsulosin: The risk and preventive strategies

Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

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Product

Resources

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Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1_aantagonist medication (tamsulosin)

Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α‐1_aantagonist medication (tamsulosin)