Academy, ASCRS Update Previous Advisory Following New Findings About Link Between Flomax and Post-Cataract Surgery Complications

The Academy and the American Society of Cataract and Refractive Surgery (ASCRS) have issued an update to their previous joint patient advisory regarding eye surgery and patients’ past, current or planned use of alpha-blockers, particularly Flomax® (tamsulosin). Recently, the lead article in the Journal of the American Medical Association reported that during a five-year study period, tamsulosin doubled the risk of serious postoperative complications following cataract surgery. No increased risk with non-selective alpha-blockers was seen. The findings of this study were widely reported in the press. The Academy and ASCRS believe this is an opportunity to reinforce and update their advice to the public about alpha-blockers and Intraoperative Floppy Iris Syndrome (IFIS).

The advisory recommends the following:

1. A patient should advise his or her ophthalmologist if he or she currently uses, or previously took, an alpha-blocker such as Flomax.
2. A patient should not decide to discontinue these drugs without first consulting his or her prescribing physician.
3. If he or she already has cataracts, the patient may wish to consult with his or her ophthalmologist before starting an alpha blocker for the first time.

The patient advisory emphasizes that if the ophthalmologist is made aware of the drug history, the success rate is still excellent and there is no need to delay or avoid cataract surgery that has been recommended.

View the Information Statement.

For more on IFIS, consult these Academy resources:

• Intraoperative Floppy Iris Syndrome (IFIS) Associated with Systemic Alpha-1 Blockers (Clinical Statement, October 2008) 
• Managing IFIS (O.N.E. video on surgical management) 
• 60 Questions: Cataract Complications and Complicated Cases (EyeNet article, February 2006) 
• Managing Intraoperative Floppy Iris Syndrome (Current Insight, Q2 2007)

If you have questions, contact Flora Lum, MD, the Academy’s policy director for quality of care and knowledge base development, at [email protected] or 415.447.0592.