Flomax (tamsulosin), a drug that is commonly used by men to treat their prostate problems, is linked to more than a double risk for serious complications following cataract surgery, indicates new study by Canadian scientists, who found that those individuals who were taking Flomax right before the operation to remove a clouded lens in the eye, were more than twice as likely to develop a complication like inflammation or detached retina, when compared to those who did not take the medication.

The drug works by relaxing muscles in and around the bladder and prostate in order to improve the flow of urine and making it easier to urinate. Being one of a class of agents called alpha-blockers, Flomax is also used by some female and male patients with kidney stones. Many of these alpha-blocker medicines are also used to treat individuals with hypertension, but Flomax was created specifically to treat an enlarged prostate. As a result, it usually causes fewer side effects.

It was recently revealed that Flomax, or tamsulosin appears to have a similar muscle-relaxing effect on the eye, resulting in, what is known as "floppy iris syndrome" in some people. "It actually complicates surgery because it acts on this area," said a lead researchers of the study, Dr. Chaim M. Bell, a scientist at the Keenan Research Centre at St. Michael's Hospital in Toronto and assistant professor at the University of Toronto, who carries out investigations on patient safety and quality of care. Post-surgical complications can mean that patients might be in need of a second or even a third surgery to fix the problem, the expert said.

Using government databases, Dr. Chaim Bell and his team at St. Michael's Hospital and the Institute for Clinical Evaluative Sciences, looked at data of more than 96,000 Ontario men with the ages 66 years and older and who underwent cataract surgery between 2002 and 2007. The investigators found that those men who were taking Flomax two weeks prior to the surgery, had a 2.3 times higher relative risk of developing a serious adverse event. Overall, among the 96,000-plus men in the research, only 284 were identified with serious complications. Among the complications:

• 175 patients had a procedure for a lost lens or lens fragment;

• 35 patients had a retinal detachment;

• 26 patients had both procedures;

• 100 patients had developed inflammation within or around the eye, a condition known as endophthalmitis.

While the absolute risk still remains not very significant - for every 256 people treated, only one will have a complication - Dr. Bell said that the aging population means more and more male patients will be treated for enlarged prostate and also be in need for cataract surgery. The expert is not certain whether stopping the drug prior to surgery would diminish the risk of complications, but he recommends that before taking Flomax, individuals should be aware of the risks associated with cataract surgery.

In addition, he said that surgeons also need to know if their patient is taking the drug, so that the procedure can be adjusted and all the risks are being taken into consideration. "A better system needs to be in place to better identify patients taking Flomax so that surgeons can best prepare during the operation," he concluded.

The findings are published in this week's issue of the Journal of the American Medical Association.

Tags: Medicine, Prostate Cancer, Eyes and Vision

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