Educational update issued on alpha-blockers and cataract surgery

The American Society of Cataract and Refractive Surgery and the American Academy of Ophthalmology recently issued a joint educational update on complications of cataract surgery associated with systemic alpha-blockers.


The American Society of Cataract and Refractive Surgery and the American Academy of Ophthalmology recently issued a joint educational update on complications of cataract surgery associated with systemic alpha-blockers.

Patients taking systemic alpha-blockers, especially tamsulosin, are more likely to experience severe intraoperative floppy iris syndrome (IFIS), or sudden iris prolapse and pupil constriction during cataract surgery. The joint educational update is based on 2 new studies published in April. The first study, published in the April Ophthalmology, found that compared with alfuzosin, tamsulosin, an alpha-blocker selective for the alpha 1-A receptor subtype, was more likely to cause severe IFIS. The second study, published in the April Journal of Cataract & Refractive Surgery, found that 35% percent of primary care physicians surveyed knew that alpha-blockers affect cataract surgery and half of this group (17%) took this into account when deciding on treatment.

The 2 organizations recommend that physicians prescribing nonemergent alpha-blocker treatment should consider whether patients have cataracts and may need surgery. Patients who have known cataracts may want to have surgery earlier or start therapy with a nonselective alpha-blocker. Alpha-blockers have no other ocular adverse effects, and patients who have already had cataract surgery do not need special considerations, the organizations noted in a press release.

The full educational update is available online.