Flomax and cataract surgery

Posted , 10 users are following.

I've been on Flomax (tamsulosin) for around a year now with generally beneficial effects on my BPH symptoms. I had cataract surgery on my right eye about 18 months ago with no problems. My optician has now referred me for surgery on my left eye and I have an appointment with the consultant opthalmic surgeon later this month. If he agrees that surgery is required I'm guessing it could be scheduled for December or January under our UK NHS system.

I'm aware that Flomax has a side effect known as "floppy iris syndrome" (FIS) which effects the integrity of the iris and can lead to complications during cataract surgery.

Has anyone the the BPH community had to deal with this as an issue? If Flomax treatment is halted for a period before surgery will that reverse the FIS? Would switching to another alpha blocker eg alfuzosin be another way to reduce/remove the FIS symptoms?

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  • Posted

    A very quick web search's first citation is from 2007, and so is not current. FWIW:

    Many eye units now advise patients to discontinue tamsulosin for 2 weeks before cataract surgery and to start taking it again immediately after surgery, though the syndrome can occur in patients who stopped therapy 1 year before surgery.

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  • Posted

    Alfuzosin does not cause floppy iris syndrome but switching to it will probably not reverse it.

    I only had it in one eye and I had stopped it some time before the procedure and the surgeon said why do they always give me the difficult ones.

    Waiting times must vary around the country and have got longer where we live in East Sussex, When I had my first one it was only a three month wait and the second was to be in six months but someone on the team told me of a cancellation so I had it in two months.

    My wife waited a year for her first one 18 months ago and they are stalling on her second one with her next appointment not until January despite her GP trying to speed it up.

    Some areas really try ! A friend in Edinburgh had her first one done on a Sunday afternoon in Livingston by a surgeon who had been operating in Carlisle in the morning and her second one done in Edinburgh.

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  • Posted

    Hi Derek76

    My estimate of wait time for surgery is based on my experience when my right eye was done.

    I know that waiting times have likely increased with the recent pressures on Health Trusts and the attitude that cataract surgery is viewed as a non-urgent procedure in some areas. How that view is sustainable I don't know. Poor eyesight can hinder the quality of life of an individual and make them more prone to accidents which could cost the NHS much more than the cataract surgery costs they save.

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  • Posted

    Hi. Not directly related to your question I'm afraid but I would be interested in knowing where you obtain your Flomax from as I have been unable to source it here in in Brighton

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    • Posted

      Has your GP prescribed it for you or are you trying to buy it yourself. It is not the best drug as it also causes retro ejaculation with many men.

      One a day Cialis is good for improving flow and has better side effects.

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    • Posted

      Hi Chris

      I have never actually received branded Flomax since my GP prescribed it. All prescriptions have been generic tamsulosin under a number of other brand names - current one is Tamfrex XL manufactured/supplied by Milpharm.

      Based in the East Midlands near Nottingham and no suggestion of supply issues here.

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    • Posted

      TO derek: I've been on Flomax (Tamsulion) for about a yr, I've not had any side affects. This is the first time I've seen Cialis suggested. Would Viagra give similar results? I'm in USA, California.

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    • Posted

      No Viagra acts differently. I noticed when using Cialis many years ago that my flow improved for a about three days when I had BPH. They then brought out a low dose one a day Cialis that is prescribed to improve flow. It also keeps you primed a ready for action when the occasion 'arises'

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    • Posted

      To Derek: ok that's interesting. I was wondering about the "rising" issue as I am 62 & just started having some issues with that, not everytime but infrequent, not completly limp but not like it used to behave. 😉. I have a script of Viagra but have not used it yet. Maybe I'll go back to my Urologist & get a script for what you suggested./ J

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    • Posted

      In the UK If Viagra or Cialis are prescribed by the NHS for ED you are only allowed four a month but to help your flow rate you can get the daily one.

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    • Posted

      Hi Arlowood,

      Thanks for your reply. I am also taking generic tamsulosin currently Pamsvax XL. I dread the thought of any kind of surgery so long may they continue to work!

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    • Posted

      I can assure you that prostate laser surgery is a piece of cake. I had GL in 2004 for my 75 grm prostate and went to the races just like a normal day on day three. When it regrew to 135 grms by 2013 I had Thulium/Holmium laser surgery and again out and about on day three.

      If you don't do something it will grow and cause bladder or possibly kidney problems later.

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  • Posted

    I was on Flomax for less than a month over a year ago and then switched to alfuzosin. One of my concerns was about floppy iris syndrome - after reading a study from the Opthalmology depart at the University of California at San Francisco. You can find the article by searching on the internet for "Alfuzosin for BPH Linked to Fewer Snags in Cataract Surgery".

    Note that in the article, alfuzosin has a lower probability of causing FIS, but there is still some risk. From my reading it appears that a man taking tamsulosin has a 34.4% chance of getting FIS whereas men taking alfuzosin have about a 16.3% chance (the control group taking no BPH drugs had a 4.4% chance).

    I asked my optometrist if she could tell if I might have FIS from a routine eye exam. She said she could and that I didn't. If this is true, then I would suggest you make an eye appt to see if you really have it. If it were me and since it looks like it might be quite awhile until you have the cataract surgery, I would switch to alfuzosin. Although Derek is most likely right that it won't reverse the effects, there might be a small chance that it will, so if alfuzosin works as well as Flomax for you, then why not try it.

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