Tamsulosin is an alpha-blocker, used to treat lower urinary tract disorders in patients with benign prostatic hyperplasia (BPH). Drugs containing this active ingredient reduce the tension of the smooth muscles of the prostate and urethra, facilitating urination and decreasing the need to urinate frequently.
In addition to acting on the enlarged prostate gland, the effect of tamsulosin is also unintentionally affecting the eye and can complicate cataract surgery, when it provides, in particular, the phacoemulsification technique (crushing of the crystalline lens with the use of ultrasound).
The drugs based on tamsulosin, in fact, are implicated in the appearance of the flag iris ("floppy-iris"), a syndrome where the colored part of the eye weakens and loses its usual consistency and resistance. Following the incision made to access the cataract nucleus, the risk is the prolapse of the iris; furthermore, the pupil tends progressively to shrink, reducing the visibility of the surgeon and making the movements necessary for the success of the operation more complex.
These adverse outcomes are reduced if the patient informs the surgeon in advance of using tamsulosin; the latter, during the planning of the intervention, can take appropriate precautions regarding the alternative drugs and surgical techniques to be used.
