Advisory to Patients Taking Prostate Medications

Medical Societies Issue Advisory to Patients Taking Prostate Medications

The American Society of Cataract and Refractive Surgery, the American Academy of Ophthalmology and the American Urological Association are advising patients taking certain drugs to treat prostate enlargement to inform their eye surgeon about these medications before undergoing eye surgery.

According to area Cataract and Refractive Specialist Jonathan M. Frantz, MD,  “Many patients and some physicians are unaware that Flomaxâ and other alpha-blockers, taken in the past or present, may complicate cataract surgery by creating a condition called Intraoperative Floppy Iris Sysdrome (IFIS).”  Dr. Frantz has had extensive experience in dealing with IFIS and has achieved excellent results with cataract patients who have had IFIS.

The effect of Flomax on cataract surgery

Because the iris is located in front of the cataract, the pupil must be widely dilated in order to perform the surgery.  A large pupil is obtained by using dilating drops that stimulate the iris dilator muscle. In a 2005 study, it was found that Flomax appears to block this iris muscle, leading to troublesome behavior of the iris during eye surgery. The iris tends to be floppy and the pupil may suddenly constrict during the middle of surgery.  If the iris problems are not anticipated, there is an increased risk of having surgical complications.  “Flomax does not affect vision or eye health;” emphasized Dr. Frantz, “however, it impairs the dilator muscle in the iris, and during cataract surgery the pupil needs to stay dilated.”

The study found that if the surgeon knows about Flomax use in advance, and modifies his surgical technique, the success rate is excellent and the complication rate is not increased in comparison to surgery on non-Flomax patients.  “We routinely ask patients if they are taking Flomax or other alph-blocker drugs so that we are prepared to deal with IFIS if necessary,” added Dr. Frantz.

“Bottom line: patients should stay on their medication as directed, and when it comes time for cataract surgery, be sure and tell your eye surgeon that you’re taking it,” explained Dr. Frantz. “Then the patient can have cataract surgery in confidence that the appropriate measures will be taken to insure their best outcomes.”

For more information on cataract surgery, visit the Florida Eye Health website at or call Dr. Frantz’s Naples office at 430-3939.

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