What is the main ocular side effect of Tamsulosin that must be considered prior to cataract surgery?

What is the main ocular side effect of Tamsulosin that must be considered prior to cataract surgery?

• A. Retinal detachment
• B. Floppy iris syndrome
• C. Cataract progression
• D. Ocular hypertension

Answer: (B)

This question hinges on recognizing that tamsulosin can cause intraoperative floppy iris syndrome during cataract surgery. Tamsulosin is an alpha-1A blocker used for BPH, and it relaxes the iris dilator muscle. That makes the iris unusually floppy, leading to billowing, poor pupil dilation that can constrict further or prolapse during the operation. Because of this risk, the surgeon must anticipate IFIS when the patient has used tamsulosin, planning accordingly with pupil-expansion techniques and careful intraoperative management. Other ocular effects listed—retinal detachment, cataract progression, and ocular hypertension—are not the characteristic preoperative concern with tamsulosin.

This question hinges on recognizing that tamsulosin can cause intraoperative floppy iris syndrome during cataract surgery. Tamsulosin is an alpha-1A blocker used for BPH, and it relaxes the iris dilator muscle. That makes the iris unusually floppy, leading to billowing, poor pupil dilation that can constrict further or prolapse during the operation. Because of this risk, the surgeon must anticipate IFIS when the patient has used tamsulosin, planning accordingly with pupil-expansion techniques and careful intraoperative management. Other ocular effects listed—retinal detachment, cataract progression, and ocular hypertension—are not the characteristic preoperative concern with tamsulosin.