title: Corneal endothelial cell changes after cataract surgery in patients on systemic sympathetic α-1a antagonist medication (tamsulosin).
abstract: OBJECTIVE
  The purpose of this study was to assess the incidence of intraoperative floppy iris syndrome (IFIS) and the morphology of the corneal endothelium after cataract extraction in Caucasian male patients exposed to the α-1a adrenergic receptor antagonist tamsulosin.
  
  
  METHODS
  In a clinical prospective study, 23 male patients (23 eyes) treated with tamsulosin due to benign prostatic hyperplasia and 25 male patients (25 eyes) with no tamsulosin treatment had cataract surgery. The divide-and-conquer technique was used with the Infinity OZil(®) machine. A combination of Healon and Healon5 was used in all patients, but the use of additional Vision Blue, iris retractors or intracameral phenylephrine in the tamsulosin group was at the discretion of the surgeon. The endothelial cell density, variation in endothelial cell size (CV), percentage of hexagonal cells and central corneal thickness (CCT) were recorded at baseline and at 3 months postoperatively.
  
  
  RESULTS
  In the tamsulosin-treated group, 19 of 23 eyes (83%) developed IFIS, compared with no IFIS in the control group. Compared with the control group, the tamsulosin group showed significantly less dilatation at the start of the operation, significant miosis during surgery and significantly greater corneal endothelial cell loss 3 months postoperatively (12% versus 3%; p< 0.001).
  
  
  CONCLUSIONS
  Intraoperative floppy iris syndrome during cataract surgery is significantly associated with tamsulosin-treated male patients. Patients on tamsulosin showed less preoperative dilatation, significant miosis during surgery, and had significantly greater postoperative endothelial cell loss compared with nontreated patients despite recommended precautions.
authors.affiliation: Department of Ophthalmology, Frederiksberg University Hospital, Frederiksberg, DenmarkRoskilde Eye Clinic, Roskilde, Denmark.
authors.forename: Allan
authors.initials: A
authors.lastname: Storr-Paulsen
authors.forename: Jesper Skovlund
authors.initials: JS
authors.lastname: Jørgensen
authors.forename: Jens Christian
authors.initials: JC
authors.lastname: Norregaard
authors.forename: Jesper
authors.initials: J
authors.lastname: Thulesen
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D058452:Axial Length, Eye; D002452:Cell Count; D048429:Cell Size; D055954:Corneal Endothelial Cell Loss / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D007431:Intraoperative Complications; D007499:Iris Diseases / Q000139:chemically induced*; D019654:Lens Implantation, Intraocular; D008297:Male; D018918:Phacoemulsification; D011183:Postoperative Complications; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000188:drug therapy; D011680:Pupil / Q000187:drug effects*; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use; D000077409:Tamsulosin; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D013449:Sulfonamides; D000077409:Tamsulosin
keywords: cataract surgery; endothelial cell density; endothelial cell morphology; intraoperative floppy iris syndrome; tamsulosin