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Author: Admin | 2025-04-28
No data to confirm a certain relationship, so it is listed as a “possible” effect.7,20 Patients who previously experienced nonarteritic anterior ischemic optic neuropathy should not take PDE5 inhibitors, as they may be at higher risk to develop it again. Based on available data from postmarketing surveillance, ocular adverse events from this class are generally benign and transient.7 Tamsulosin and Selective Alpha1A-Blockers Tamsulosin is a selective alpha1A antagonist commonly used for the treatment of BPH. Tamsulosin and other selective alpha1A antagonists, such as silodosin, have been associated with intraoperative floppy iris syndrome (IFIS).23 IFIS, to a lesser extent, has also been associated with nonselective alpha antagonists.24 Dilation of the pupil is necessary to reduce the risk of complications during cataract surgery and is achieved with the use of mydriatic agents. Blockade of alpha1A receptors causes a relaxation of the iris dilator, rendering the agents used during the procedure ineffective.23,25 Complications that may result include iris prolapse, pupillary miosis, iris trauma, iris aspiration, and vitreous loss. IFIS is seen mainly during cataract surgery and to a lesser extent in glaucoma surgery.23 In 2010, there were over 24 million cataract surgeries, with the number expected to grow to almost 39 million by the year 2030.26 Although alpha-blockers are used primarily in men for BPH, women can still be at risk for developing IFIS, as these agents can be used for the treatment of other bladder problems and hypertension.25 It is important to know if alpha-blockers are used prior to cataract surgery, since discontinuation has not been effective in preventing IFIS and is not a recommended strategy.25 Use of atropine drops or epinephrine dilution can be considered as prophylaxis prior to surgery. Application of atropine 1% drops has shown success in providing mydriasis, but patients often require another intervention. Intracameral administration of diluted
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