July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Practice patterns of urologists regarding use of pre-operative prophylactic alpha blockers at academic medical centers in the United States: a national survey
Author Affiliations & Notes
  • Gaytri Gupta Elera
    Ophthalmology, Penn State Eye Center, HUMMELSTOWN, Pennsylvania, United States
  • Ingrid U Scott
    Ophthalmology, Penn State Eye Center, HUMMELSTOWN, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Gaytri Gupta Elera, None; Ingrid Scott, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4777. doi:
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      Gaytri Gupta Elera, Ingrid U Scott; Practice patterns of urologists regarding use of pre-operative prophylactic alpha blockers at academic medical centers in the United States: a national survey. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4777.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Many studies advocate the use of prophylactic alpha-adrenergic receptor antagonists, also known as alpha blockers, prior to surgery to reduce postoperative urinary retention. However, these agents have been associated with intraoperative floppy iris syndrome (IFIS). Studies have shown that IFIS may occur despite discontinuing alpha blockers years prior to cataract surgery, and it has also been reported that IFIS can occur after only one dose of an alpha blocker.

The purpose of this study is to explore practice patterns among urologists in the United States regarding the use of prophylactic alpha blockers prior to surgery.

Methods : An anonymous, web-based survey containing multiple-choice questions was emailed to the director of each urology residency program accredited by the Accreditation Council for Graduate Medical Education. Non-responders received reminder emails and phone calls.

Results : Forty percent of respondents reported they prescribe prophylactic alpha blockers prior to at least 10% of surgeries, depending on factors including gender (67%), type of surgery (67%), age (58%) and obesity (9%). Forty percent of respondents reported that, prior to prescribing alpha blockers, they never ask about previous history of cataract surgery, 18% occasionally ask their patients, 9% sometimes ask their patients, and 27.3% always ask their patients. Twenty-seven percent of respondents reported that a patient’s history of prior cataract surgery would have no effect on their decision to prescribe prophylactic alpha blockers, nor on their decision of which one to prescribe, while 9% reported that a patient history of prior cataract surgery would affect which alpha blocker they prescribe. If the patient has not had cataract surgery, 40% prefer tamsulosin, 20% prefer alfuzosin and 40% had no preference. When asked whether, prior to prescribing a prophylactic alpha blocker, they counsel patients on the risk of IFIS and the implications of IFIS for future cataract surgery, 40% responded that they routinely counsel patients, 20% reported they usually counsel patients, 10% occasionally counsel patients and 30% reported they never counsel patients regarding these issues.

Conclusions : There is an opportunity to decrease the incidence of IFIS through education of urologists regarding the association of alpha-adrenergic receptor antagonists with IFIS.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

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