Surgical outcome following iris related intraoperative difficulties in patients on tamsulosin (Flomax) undergoing phacoemulsification

Abstract

Abstract Purpose: To determine whether iris related intraoperative difficulties during phacoemulsification in patients on tamsulosin (Flomax) affects surgical outcome. Methods: A retrospective case control study of consecutive patients undergoing phacoemulsification at Queen Alexandra Hospital, Portsmouth, UK. Pre‐operative pupil size, iris and non‐iris related intraoperative complications, and post‐operative best corrected Snellen visual acuity (BCVA) were examined. Two‐tailed Fisher exact test was used. Results: Data from 9605 eyes of 6763 consecutive patients were analysed. 108 eyes were of male patients on tamsulosin (TG). The remaining 2862 eyes of male patients formed the control group (NT). The use of tamsulosin was 1.3% amongst all patients. ‘Small’ pre‐operative pupil size occurred with increased statistical significance in patients on tamsulosin (TG: 14.8%, NT: 2.5%, p<0.0001). Iris related intraoperative difficulties also occurred with increased frequency (TG: 36.1%, NT: 2.7%, p<0.0001), however vision‐threatening complications did not occur significantly in this group (TG: 2.8%, NT: 1.5% P = 0.22). At one month follow up, BCVA of 6/12 or better was achieved in 94% of cases on tamsulosin and 92% of controls. (P = 0.37) Conclusions: A higher prevalence of intraoperative iris‐related difficulties was found in patients taking tamsulosin. However, this was not associated with increased prevalence of vision threatening complications or adverse visual outcome post‐operatively