Resident-performed phacoemulsification surgery in tamsulosin-treated patients.
OBJECTIVE
To compare intraoperative complication rates and visual outcomes for patients treated and not treated with tamsulosin hydrochloride who underwent resident-performed phacoemulsification, and to determine whether the recognition of intraoperative floppy iris syndrome in 2005 affected the subsequent complication rates for tamsulosin-treated patients.


METHODS
This comparative retrospective cohort study included 101 tamsulosin-treated eyes and 404 non-tamsulosin-treated eyes from January 1, 1998, to August 31, 2008. Main outcome measures were major and minor complication rates and postoperative best-corrected visual acuity. Complication rates were compared between August 11, 1999, to December 31, 2005, and January 1, 2006, to September 3, 2008, for both tamsulosin-treated and non-tamsulosin-treated eyes.


RESULTS
The major complication rates were 3.0% for tamsulosin-treated eyes and 8.9% for non-tamsulosin-treated eyes (P = .08), while the minor complication rates were 24.8% and 12.1%, respectively (P = .002). Both groups had an equal likelihood of attaining better than 20/40 postoperative visual acuities (82.2% vs 82.9%, respectively; P = .85). Frequency of major complications between tamsulosin-treated and non-tamsulosin-treated eyes was 6.0% vs 15.8%, respectively (P = .09), from August 11, 1999, to December 31, 2005, compared with 0.0% vs 2.0%, respectively (P > .99), from January 1, 2006, to September 3, 2008.


CONCLUSIONS
Differences in the major complication rates for tamsulosin-treated and non-tamsulosin-treated eyes were not significant, whereas tamsulosin exposure was associated with a significant increase in minor complications. Both groups had similar, good postoperative visual outcomes. After 2005, a reduction in major complications was seen in both groups, attributed to programmatic changes in surgical education. Recognition of intraoperative floppy iris syndrome did not impart a significant additional protective effect in preventing major complications.
Ku
Tina K
TK
Department of Ophthalmology, University of California, USA.
Rutar
Tina
T
Han
Ying
Y
Porco
Travis C
TC
Naseri
Ayman
A
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000368:Aged; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007431:Intraoperative Complications; D007499:Iris Diseases / Q000139:chemically induced; D008297:Male; D009885:Ophthalmology / Q000193:education / Q000706:statistics & numerical data*; D018918:Phacoemulsification; D010818:Practice Patterns, Physicians'; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D011471:Prostatic Neoplasms / Q000188:drug therapy; D012189:Retrospective Studies; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D000077409:Tamsulosin; D014792:Visual Acuity / Q000502:physiology
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin