Bigdon Eileen, Casagrande Maria, Spitzer Martin Stephan, Hassenstein Andrea
Augenzentrum Schleswig-Holstein, Neumünster.
Universitätsklinikum Hamburg-Eppendorf, Opthalmology, Hamburg.
Aktuelle Urol. 2022 Jun;53(3):246-253. doi: 10.1055/a-1199-6900. Epub 2021 Mar 10.
Tamsulosin is one of the most commonly prescribed alpha-1A antagonists for the treatment of benign prostatic syndrome (BPS). Patients treated with tamsulosin often develop intraoperative floppy iris syndrome (IFIS) during cataract surgery. This leads to increasing miosis and an undulating iris, which increases the risk of complications significantly and can cause permanent damage.
The aim is to raise awareness for the effects of tamsulosin intake before cataract surgery.
We conducted a critical review of publications on the association of IFIS in cataract surgery with alpha-receptor blockers.
Tamsulosin has a risk of complications of up to 80 %, whereas doxazosin and alfuzosin only have a 15-20 % chance of complications. Tamsulosin therefore represents a significant risk factor for permanent secondary damage after cataract surgery. Even after discontinuing tamsulosin, IFIS was still observed after up to 3 years. Nevertheless, pausing of tamsulosin intake is recommended. An alternative preparation should therefore be preferred in patients who have not yet had cataract surgery. If patients are already pseudophakic, tamsulosin can be given without concern.
坦索罗辛是治疗良性前列腺综合征（BPS）最常用的α-1A拮抗剂之一。接受坦索罗辛治疗的患者在白内障手术期间常发生术中虹膜松弛综合征（IFIS）。这会导致瞳孔缩小加剧和虹膜波动，显著增加并发症风险，并可能造成永久性损害。
目的是提高对白内障手术前服用坦索罗辛影响的认识。
我们对关于白内障手术中IFIS与α受体阻滞剂关联的出版物进行了批判性综述。
坦索罗辛的并发症风险高达80%，而多沙唑嗪和阿夫唑嗪的并发症几率仅为15%-20%。因此，坦索罗辛是白内障手术后永久性继发性损害的一个重要风险因素。即使停用坦索罗辛，长达3年后仍观察到IFIS。尽管如此，仍建议暂停服用坦索罗辛。因此，对于尚未进行白内障手术的患者，应优先选择替代制剂。如果患者已经植入人工晶状体，则可以放心服用坦索罗辛。
