Evolution in the Risk of Cataract Surgical Complications among Patients Exposed to Tamsulosin A Population-Based Study

被引：16
作者：
Campbell, Robert J. [1 ,2 ,3 ]
El-Defrawy, Sherif R. [4 ,5 ]
Gill, Sudeep S. [3 ,6 ,7 ]
Whitehead, Marlo [3 ,8 ]
Campbell, Erica de L. P. [1 ,2 ]
Hooper, Philip L. [9 ,10 ]
Bell, Chaim M. [3 ,11 ,12 ,13 ]
ten Hove, Martin W. [1 ,2 ]
机构：
[1] Queens Univ, Dept Ophthalmol, Kingston, ON, Canada
[2] Kingston Hlth Sci Ctr, Dept Ophthalmol, Hotel Dieu Hosp Site,166 Brock St, Kingston, ON K7L 5G2, Canada
[3] Inst Clin Evaluat Sci, Toronto, ON, Canada
[4] Univ Toronto, Dept Ophthalmol, Toronto, ON, Canada
[5] Kensington Eye Inst, Dept Ophthalmol, Toronto, ON, Canada
[6] Queens Univ, Div Geriatr Med, Kingston, ON, Canada
[7] Providence Care Hosp, Div Geriatr Med, Kingston, ON, Canada
[8] Queens Univ, Kingston, ON, Canada
[9] Western Univ, Dept Ophthalmol, London, ON, Canada
[10] St Josephs Hosp, Dept Ophthalmol, London, ON, Canada
[11] Univ Toronto, Dept Med, Toronto, ON, Canada
[12] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[13] Sinai Hlth Syst, Dept Med, Toronto, ON, Canada
来源：
OPHTHALMOLOGY | 2019年 / 126卷 / 04期
关键词：
FLOPPY IRIS SYNDROME; ADVERSE EVENTS; SURGERY; CARE; PREVALENCE; MANAGEMENT; INHIBITORS; OUTCOMES; RATES;
D O I：
10.1016/j.ophtha.2018.11.028
中图分类号：
R77 [眼科学];
学科分类号：
100212 ;
摘要：
Purpose: Tamsulosin is associated with intraoperative floppy iris syndrome (IFIS), an important risk factor for complications during cataract surgery. Significant efforts have been made to increase awareness of the risks associated with tamsulosin, and educational initiatives have fostered the uptake of technical adjustments to decrease adverse event rates among tamsulosin-exposed patients. However, the effectiveness of these efforts at the population level has not been studied. Design: Population-based study to evaluate cataract surgical adverse event rates over time among patients exposed to tamsulosin and those not exposed to this drug. Participants: All male patients 66 years of age and older undergoing cataract surgery in Ontario, Canada, between January 1, 2003, and December 31, 2013, were included in the study. Methods: Linked healthcare databases were used to study the evolution in the risk of cataract surgical adverse events over time among tamsulosin-exposed and non-tamsulosin-exposed patients adjusting for patient-, surgeon-, and institution-level covariates. The study timeframe incorporated periods before and after the first reports of tamsulosin-associated IFIS. Main Outcome Measures: Four important cataract surgical adverse events were evaluated: posterior capsule rupture, dropped lens fragments, retinal detachment, and suspected endophthalmitis. Results: Among patients exposed to tamsulosin, the risk of surgical adverse events decreased over time (odds ratio, 0.95 per year; 95% confidence interval, 0.91-0.99 per year). This trend was observed across patient age strata. Among patients not recently exposed to tamsulosin, the risk of surgical adverse events also decreased over time (odds ratio, 0.96 per year; 95% confidence interval, 0.95-0.98 per year). Conclusions: The risk of cataract surgical complications among both tamsulosin-exposed and nonetamsulosin-exposed patients declined between 2003 and 2013. Tamsulosin remains an important risk factor for cataract surgical adverse events, and ongoing efforts will be needed to develop and disseminate surgical approaches that mitigate the risks posed by tamsulosin. Ophthalmology 2019; 126: 490-496 (C) 2018 by the American Academy of Ophthalmology
引用
收藏
页码：490 / 496
页数：7
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