Will i need to stop taking my prostate medication before surgery for my cataracts? i'll need cataract surgery in the coming year. i take flomax (tamsulosin) for an enlarged prostate. does this or any other drug cause a problem with cataract treatment?

I : I agree---going off the medicine does not good. Just let your doctor know that you are on it and he can take the necessary operative precaustions during the surgery. Don't let this stop you from having the surgery that will improve your vision.

Flomax (tamsulosin) : Flomax (tamsulosin) is the most commonly prescribed drug to treat prostate enlargement, or benign prostate hyperplasia (bph). Flomax (tamsulosin) and other drugs in the alpha-blocker class decrease the need to urinate in the middle of the night. Flomax (tamsulosin) does not adversely affect the eye or vision, but it does adversely affect cataract surgery by preventing the pupil to adequately dilate during the procedure. This condition has been coined intraoperative floppy iris syndrome (ifis). Ifis has been associated with an increased complication rate during cataract surgery. It is very important for the patient to advise their ophthalmologist that they are taking Flomax (tamsulosin) if they are to undergo cataract surgery. In my practice, i take the following steps to insure an excellent surgical outcome: + discontinue Flomax (tamsulosin) several weeks prior to surgery, if possible. +prescribe a long acting dilating drops 1 week prior to surgery. +use a dilating medication in the eye during surgery. +use a new device called the malyugin ring during cataract surgery in order to ensure adequate pupil dilation. Recent television commercials touting the effectiveness of Flomax (tamsulosin) state the following warning: “Flomax (tamsulosin) is an excellent prostate medication, and there is no need for patients to avoid it or stop taking it out of concern over eye problems. However, the key is for patients to inform their ophthalmologist when they are taking this or any other prostate drugs prior to eye surgery.” i will add some controversary to this post by suggesting that any patient who is about to be prescribed Flomax (tamsulosin) see their ophthalmologist before starting flomax (tamsulosin). If even a small cataract is noted, i would advise its removal before starting the flomax (tamsulosin). I am convinced this will lead to a much safer surgical outcome!

I : I perform ~1500 cataract surgeries per year and see many patients on Flomax (tamsulosin) and similar medications that cause floppy iris syndrome. It should be noted that stopping Flomax (tamsulosin) does not prevent iris from becoming floppy. For this reason, I do not ask my patients to stop taking their medications. The key to performing cataract surgery on patients with Flomax (tamsulosin) is to minimizing manipulation of the iris and to perform the surgery as quickly as possible. The patient should ask how many patients on Flomax (tamsulosin) their ophthalmologist have performed.

No: You do not need to stop your prostate medicine prior to cataract surgery.