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Christopher T. Hood, Munira Hussain, Theresa M. Cooney, Victor M. Elner, Roni M. Shtein; The Effect of Tamsulosin (Flomax) on Iris Vasculature. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6705.
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To determine whether iris vasculature is altered in patients who have taken tamsulosin (Flomax).
In this prospective, case-control study, iris fluorescein angiography (FA) was performed prior to cataract surgery in 13 eyes of 13 patients with current or past tamsulosin use, and 6 eyes of 6 age and sex-matched control patients. Time to first dye appearance was recorded. The image of maximal fill was identified and the percentage of vessel fill per iris area was calculated using Metamorph software. Pupillary diameter was measured before and immediately after phacoemulsification cataract surgery. Clinical signs of intraoperative floppy iris syndrome (IFIS) including iris billowing, progressive miosis, or iris prolapse as well as surgical complications were recorded.
The mean age was 71 ± 9 yrs for tamsulosin patients and 68 ± 11 yrs for controls (p=0.55). Four subjects had used tamsulosin in the past and 9 were currently taking the medication, with a range of use from 3 weeks to 15 years. Seven of the tamsulosin patients, with mean age 68 ±10 yrs had at least one of the clinical signs of IFIS. No surgical complications occurred in any patient. Time to first dye appearance was not statistically different between tamsulosin patients and controls (33 ± 16 s vs 28 ± 5 s, p=0.45), or between tamsulosin patients with IFIS (29 ± 6 s) and controls (p=0.63). There was no significant difference in pre and post-operative pupil size between tamsulosin patients and controls, and no significant change in pupillary diameter from pre to post-operatively in either group. The mean percentage of vessel fill for controls (15.9 ± 6.5%) was not significantly different from all tamsulosin patients (15.7 ± 3.7%) or those that had intraoperative signs of IFIS (13.7 ± 1.5%, p=0.93 and 0.4). No fluorescein dye leakage, staining, or other iris vascular anomalies were found in any patient.
Iris FA performed on patients with past or current tamsulosin use did not demonstrate significant differences in iris vasculature as compared to control patients.
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