Cataract surgery complications associated with tamsulosin (Flomax), used to treat enlarged prostates and to help with the passage of kidney stones, decreased significantly over a decade, according to a large Canadian study.  

The Kingston Health Sciences Centre, Ontario, database study of 378,611 males undergoing cataract surgery between 2003-2013 found posterior capsule rupture, dropped lens fragments, retinal detachment, and suspected endophthalmitis decreased during the period. Authors said education about tamsulosin-associated intraoperative floppy iris syndrome (IFIS) and adaptations such as the use of mechanical pupil expansion and viscoadaptive ophthalmic viscosurgical devices, as well as fluidic parameter optimisation and intensive pharmacologic pupil dilation, likely played a role in the decrease. 

Although cataract complications among non-tamsulosin patients also decreased in the same period, authors said tamsulosin remains an important risk factor for cataract surgical adverse events and ongoing efforts will be needed to develop and disseminate surgical approaches that mitigate the risks the drug poses.