Flomax (Tamsulosin) and Cataract Surgery

Along with Uroxatral (Alfuzosin), Cardura (Doxazosin), Silodal (Silodosin), and Hytrin (Terazosin)

One of the most common questions I encounter from patients undergoing cataract surgery has to do with whether their use of Flomax or other similar Urologic medications will adversely affect the outcome of their surgery. The answer to that question is possibly, but in recent years we as ophthalmologists and eye surgeons have made considerable progress in reducing any added risk to patients scheduled for cataract surgery who are taking these medications. As a group these medications are given primarily but not exclusively to men for the treatment of prostate disease and occasionally to both men and women for the treatment of kidney stones. These medications relax a certain type of muscle fiber called smooth muscle which is helpful in promoting urination in men with an enlarged prostate or in passing a kidney stone.

In the eye, the pupil is the colored portion of the eye which serves to regulate how much light enters the eye when it opens and closes, much like the aperture of a camera. The size of the pupil and its ability to open and close is regulated by smooth muscle. The pupil is in the front of the lens of the eye and in order for a surgeon to remove a cataract which is a cloudy lens; the pupil must be dilated and kept out of the way of during surgery. The pupils of patients who have been treated with Flomax or any of these medications can become very floppy and interfere with delicate manipulations necessary within the eye to remove a cataract safely. Early on when these medications were first being used, we as ophthalmologists were unaware that this group of medications had such a profound effect on the way the pupil behaved in the eye while performing cataract surgery. Now, with advance knowledge that patients are taking these medication surgeons can take steps to manage the pupil better during surgery with the help of additional pharmacologic agents and mechanical devices used during surgery to stabilize the movement of the pupil. Nevertheless, despite using all the appropriate steps to better manage the pupil, cataract surgery in patients who have ever taken one of these medications remain at slightly increased risk for a complication. However, the eventual need for cataract surgery should not prevent patients from choosing to use these medications for appropriate indications, since eye surgeons have made considerable progress in preventing complications from cataract surgery in this setting. The most important take home message for patients needing cataract surgery, who also have urologic disease, is to be sure to tell your eye surgeon the name of the medication and why you take it. This will ensure that your eye surgeon is prepared and gives you the best chance for an excellent visual result.

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