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Benign prostatic hyperplasia. Clinical treatment can complicate cataract surgery
Fernando Facio1, Renata Kashiwabuschi, Yutaro Nishi
1Department of Urology, Faculty of Medicine of Sao Jose do Rio Preto, Sao Paulo, Brazil. fnfacio@yahoo.com.br
Summary
Alpha-1 adrenergic receptor antagonists used for benign prostatic hyperplasia (BPH) can increase the risk of intraoperative floppy iris syndrome (IFIS) during cataract surgery. Patients should discuss these risks with their doctors before surgery.
Area of Science:
- Ophthalmology
- Urology
- Pharmacology
Background:
- Benign prostatic hyperplasia (BPH) is a common condition in aging men.
- Alpha-1 adrenergic receptor antagonists are frequently prescribed for BPH symptoms.
- Cataract surgery is a common procedure, particularly in older populations.
Purpose of the Study:
- To investigate the potential risks of alpha-1 adrenergic receptor antagonists in patients undergoing cataract surgery.
- To review the association between these medications and intraoperative floppy iris syndrome (IFIS).
- To provide recommendations for managing patients on these medications prior to cataract surgery.
Main Methods:
- A comprehensive literature review was conducted using MEDLINE.
- Search terms included "benign prostatic hyperplasia", "intraoperative floppy iris syndrome", "adrenergic alpha-antagonist", and "cataract surgery".
- Publications from 2001 to 2009 were reviewed, including reference lists.
Main Results:
- The first report of IFIS during cataract surgery in patients taking alpha-1 AR antagonists emerged in 2005.
- Tamsulosin was most commonly associated with IFIS.
- Medication changes and washout periods of up to two weeks were explored to mitigate risks.
Conclusions:
- Patients treated for BPH with alpha-1 AR antagonists should be informed of IFIS risks.
- Discussion with healthcare providers, including urologists and ophthalmologists, is crucial before cataract surgery.
- Informed consent and careful preoperative planning are essential for patient safety.
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