Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

Teper, Sławomir; Dobrowolski, Dariusz; Wylęgała, Edward

doi:10.5173/ceju.2011.02.art2

Cited by 6 publications

(4 citation statements)

References 44 publications

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“…Men are more prone to ocular trauma that might have occurred decades ago, which can be ignored and left untreated until the time of cataract surgery. In addition, several causes of zonule weakness are known to be predominant in men, including intraoperative floppy iris syndrome associated with the use of alpha-adrenergic receptor antagonists for treating benign prostate hyperplasia 48 and connective tissue disorders, such as Marfan syndrome 49 .…”

Section: Discussionmentioning

confidence: 99%

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

Choi

Lee

Kang

et al. 2021

Sci Rep

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We aimed to investigate the efficacy and safety of primary retropupillary iris claw intraocular lens (R-IOL) implantation in patients with complete intraocular lens (IOL) dislocation. In this single-center retrospective case series, we reviewed the medical records of patients who underwent R-IOL implantation surgery with pars plana vitrectomy for the treatment of IOL dislocation between September 2014 and July 2019. The primary outcome was change in visual acuity (VA) up to 24 months postoperatively. The secondary outcomes included changes in intraocular pressure (IOP), refractive errors, and endothelial cell count (ECC) over the same period. Data of 103 eyes (98 patients) were analyzed. The mean uncorrected VA was significantly improved at one month postoperatively (− 0.69 logMAR, P < 0.001), compared to the preoperative value. IOP (− 2.3 mmHg, P = 0.008) and ECC (− 333.4 cells/mm2, P = 0.027) significantly decreased one month post-surgery and remained stable thereafter. Postoperative mean spherical equivalents were similar to the prediction error throughout the follow-up period. IOP elevation (n = 8, 7.8%), cystoid macular edema (n = 4, 3.9%), and dislocation of the R-IOL (n = 10, 9.7%) were managed successfully. Overall, primary R-IOL implantation with pars plana vitrectomy is effective and safe for correcting IOL dislocation due to various causes.

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Section: Discussionmentioning

confidence: 99%

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

Choi

Lee

Kang

et al. 2021

Sci Rep

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“…Although the NQF measure is considered a good indicator of the quality of care, it was intended by the clinical experts who developed it to reflect the quality of services provided for patients who receive uncomplicated cataract surgery 17 . The measure identifies a clinically homogeneous low‐risk cohort of cataract patients 28 and excludes patients with documentation of the presence of one or more preoperative ocular conditions (eg, glaucoma, corneal edema and traumatic cataract) or specific medication use (tamsulosin) (Appendix ), whose history puts them at increased risk of postoperative complications after cataract surgery 17,29,30 …”

Section: Methodsmentioning

confidence: 99%

Comparing cataract surgery complication rates in veterans receiving VA and community care

Rosen

Vanneman

O’Brien

et al. 2020

Health Services Research

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Objectives: To compare 90-day postoperative complication rates between Veterans receiving cataract surgery in VA vs Community Care (CC) during the first year of implementation of the Veterans Choice Act. Data Sources: Fiscal Year (FY) 2015 VA and CC outpatient data from VA's Corporate Data Warehouse (CDW) 10/01/14-9/30/15). FY14 data were used to obtain baseline clinical information prior to surgery. Study Design: Retrospective one-year study using secondary data to compare 90day complication rates following cataract surgery (measured using National Quality Forum (NQF) criteria) in VA vs CC. NQF defines major complications from a specified list of Current Procedural Terminology (CPT) codes. We ran a series of logistic regression models to predict 90-day complication rates, adjusting for Veterans' sociodemographic characteristics, comorbidities, preoperative ocular conditions, eye risk group, and type of cataract surgery (classified as routine vs complex). Data Collection: We linked VA and CC users through patient identifiers obtained from the CDW files. Our sample included all enrolled Veterans who received outpatient cataract surgery either in the VA or through CC during FY15. Cataract surgeries were identified through CPT codes 66 984 (routine) and 66 982 (complex).

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“…Cataract surgery is the second most cost effective health intervention [ 10 ]. As many as 30% of adults over 65 suffer from cataracts, and more than 8 million of these patients undergo surgical cataract treatment every year according to WHO data [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Ten years of intraoperative floppy iris syndrome (IFIS) in the era of α-blockers

Lunacek

Radmayr

et al. 2018

CEJU

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IntroductionThe use of alpha-1 receptor antagonists in the treatment of benign prostatic hyperplasia (BPH) has created a problem in ophthalmic surgery, the so-called intraoperative floppy iris syndrome (IFIS). This consists of a billowing iris, insufficient pupillary dilation with progressive intraoperative miosis, and protrusion of iris tissue through the tunnel and side port incision that are made for access to the anterior chamber during surgery. IFIS presents particular difficulties in cataract surgery which is carried out through the pupil with manipulations in the immediate vicinity of the iris. The complications range from poor visibility of the operative field to iris damage with the surgical instruments and to rupture of the posterior capsule, with loss of lens material into the vitreous body.Material and methodsA comprehensive literature review was performed using MEDLINE with MeSH terms and keywords ‘benign prostatic hyperplasia’, ‘intraoperative floppy iris syndrome’, ‘adrenergic alpha-antagonist’ and ‘cataract surgery’. In addition, reference lists from identified publications were reviewed to identify reports and studies of interest from 2001 to 2017.ResultsThe A total of 95% of experienced ophthalmologic surgeons reported that systematic treatment with tamsulosin represents a challenging surgical condition increasing the risk of complications. Alpha-blockers are commonly prescribed, with 1,079,505 packages of tamsulosin prescribed each month in 2014 in Austria. Dose modification may be one way to reduce the risk of IFIS. A lower incidence of IFIS was reported in patients on tamsulosin in Japan, but the recommended dosage was lower than that used in Europe and the US (0.2 mg vs. 0.4 mg).ConclusionsWe showed that not all patients taking tamsulosin experience IFIS. Moreover, larger investigations with a prospective design are needed, including studies to monitor the pre- and post-therapeutic ophthalmologic changes under tamsulosin, as well as urodynamic improvements resulting from this therapy.

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Complications of cataract surgery in patients with BPH treated with alpha 1A-blockers

Cited by 6 publications

References 44 publications

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

Long-term surgical outcomes of primary retropupillary iris claw intraocular lens implantation for the treatment of intraocular lens dislocation

Comparing cataract surgery complication rates in veterans receiving VA and community care

Ten years of intraoperative floppy iris syndrome (IFIS) in the era of α-blockers

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