Tamsulosin linked to incision rupture

This retrospective case-control study found that patients who took tamsulosin had a higher risk of wound dehiscence after cataract surgery. 

While this study has many weaknesses and doesn’t identify the type of incision used, it identified a problem that had not been previously noticed. The authors suggest that suturing incisions in patients taking tamsulosin before cataract surgery may decrease postsurgical wound dehiscence.

They included 4,474 patients in Taiwan who had undergone cataract surgery and taken an α₁-blocker before surgery who were matched by age, sex and year of surgery with 4,474 cataract surgery patients who did not take α₁-blockers preoperatively.

The percentage of surgery–related complications was 8.61% in the group treated with α₁-blockers and 8% in the control group, which was similar. However, in the 922 patients in the α₁-blocker group who took tamsulosin before surgery, wound dehiscence was 3.81 times higher than in the control group (0.65% vs. 0.18%).

Although the authors could not directly identify which patients had intraoperative floppy iris syndrome (IFIS), for which many published studies say the use of tamsulosin is a risk factor, they say the increased risk of incision rupture in patients taking tamsulosin might be associated with IFIS.

They suggest that ophthalmologists take a careful medication history before cataract surgery in order to prevent surgery-related complications and additional costs of reoperation.