Complications of cataract surgery in Wistar rats undergoing treatment with tamsulosin

Popescu,Raluca  Maria; Ober,Ciprian; Sevastre,Bogdan; Taulescu,Marian; Negru,Mihai; Melega,Iulia; Bogdan,Sidonia; Nicula,Cristina; Coman,Ioan

doi:10.3892/etm.2018.6904

Complications of cataract surgery in Wistar rats undergoing treatment with tamsulosin

Authors:
- Raluca Maria Popescu
- Ciprian Ober
- Bogdan Sevastre
- Marian Taulescu
- Mihai Negru
- Iulia Melega
- Sidonia Bogdan
- Cristina Nicula
- Ioan Coman
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Affiliations: Department of Surgical Specialties, Faculty of General Medicine, ‘Iuliu Haţieganu’ University of Medicine and Pharmacy, 400012 Cluj‑Napoca, Romania, Clinical Department, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj‑Napoca, Romania, Paraclinical Department, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj‑Napoca, Romania
Published online on: October 31, 2018 https://doi.org/10.3892/etm.2018.6904
Pages: 137-146
Copyright: © Popescu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the study was to identify if there is a connection between the time of administration of alpha‑blocker medication and cataract surgery complications. Furthermore, it was explored whether discontinuation of tamsulosin before cataract surgery influences the manifestations of intraoperative floppy iris syndrome in rats. An experimental study was conducted on 20 male Wistar rats aged 1.5‑2 years (body mean weight 357 g), which were divided into four equal groups: Group 1, under tamsulosin hydrochloride 0.4 mg/day for 2 months; group 2, without any treatment in the first month, followed by tamsulosin; group 3, under tamsulosin for 1 month, followed by 1 month without any treatment; and group 4, control. The pupillary diameter was assessed before instillation of 0.5% tropicamide (mydriatic and cycloplegic agent), after 1 or 2 h from instillation and postoperatively. Furthermore, pupil constriction during surgery, the presence of floppy iris and prolapse of the iris following the main incision and during serum injection were also assessed. Other analyzed features included iris rupture, posterior capsule tear, vitreous loss, lens fragments in the vitreous, suprachoroidal bleeding and corneal haze. The iris dilator muscle thickness and the posterior epithelium was measured using light microscopy. In the control group, the largest pupillary diameters were indicated and in group 1, the smallest pupillary diameters were revealed. Statistically significant differences were indicated between group 1 and 2 and group 3 and 4. Floppy iris, iris prolapse in the main incision and during serum injection appeared at maximum frequency for group 1 with continuous treatment and low frequency for the control group. Lens fragments in the vitreous were present in the groups 1‑3. Notably, intraoperative miosis had statistical relevance in group 1 and group 2. To conclude, the present findings suggested there is a clear connection between the time of administration of the alpha‑blocker medication and most cataract complications. The results indicated that discontinuation of tamsulosin for one month largely reduces the manifestations of intraoperative floppy iris syndrome in rats, which may suggest to change preoperative treatment for benign prostatic hypertrophy with another class of drugs that do not interact with the iris receptors.

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1	Flach AJ: Intraoperative floppy iris syndrome: Pathophysiology, prevention, and treatment. Trans Am Ophthalmol Soc. 107:234–239. 2009.PubMed/NCBI
2	Chang DF and Campbell JR: Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg. 31:664–673. 2005. View Article : Google Scholar : PubMed/NCBI
3	Janjua S and Cremers S: Managing intraoperative floppy iris syndrome. Cataract removal surgery and intraocular lens implantation: HS-100. 3–5. 2016.
4	Nakamura S, Tanigukhit T, Suzuki F, Akagi Y and Muramatsu I: Evaluation of alfa1 adrenoreceptors in the rabbit iris: Pharamcological caracterisation and expression of m RNA. Br J Pharmacol. 127:1367–1374. 1999. View Article : Google Scholar : PubMed/NCBI
5	Chang DF, Braga-Mele R, Mamalis N, Masket S, Miller MK, Nichamin LD, Packard RB and Packer M; ASCRS Cataract Clinical Committee, . ASCRS white paper: Clinical review of intraoperative floppy-iris syndrome. J Cataract Refract Surg. 34:2153–2162. 2008. View Article : Google Scholar : PubMed/NCBI
6	Nicula C, Nicula D and Popescu R: Intraoperative floppy iris syndrome-a prospective study. Oftalmologia. 57:38–44. 2013.(In Romanian). PubMed/NCBI
7	Mamalis N: Importance of pupil dilation for cataract surgery. J Cataract Refract Surg. 43:583–584. 2017. View Article : Google Scholar : PubMed/NCBI
8	Chiseliţă D, Cantemir A, Epifanov L, Huţuleac A and Irod A: Management of intraoperative floppy iris syndrome. Oftalmologia. 56:69–76. 2012.(In Romanian).
9	Storr-Paulsen A, Jørgensen JS, Norregaard JC and Thulesen J: Corneal endothelial cell changes after cataract surgery in patients on systemicsympathetic α-1a antagonist medication (tamsulosin). Acta Ophthalmol. 92:359–363. 2014. View Article : Google Scholar : PubMed/NCBI
10	Klysik A and Korzycka D: Sub-tenon injection of 2% lidocaine prevents intra-operative floppy iris syndrome (IFIS) in male patients taking oral α-adrenergic antagonists. Acta Ophthalmol. 92:535–540. 2014. View Article : Google Scholar : PubMed/NCBI
11	Lorente R, de Rojas V, Vázquez de Parga P, Moreno C, Varela J, Landaluce ML, Méndez J and Lorente B: Intracameral phenylephrine 1.5% for prophylaxis against intraoperative floppy iris syndrome: Prospective, randomized fellow eye study. Ophthalmology. 119:2053–2058. 2012. View Article : Google Scholar : PubMed/NCBI
12	Chao DL, Modi YS, Lee B, Sridhar J, Kuriyan AE and Gedde SJ: Review of effects of tamsulosin and silodosin on isolated albino and pigmented rabbit iris dilators: Possible mechanism of intraoperative floppy-iris syndrome. Eye World ASCRS Publication. 2012.
13	Masket S and Chang DF: Intraoperative Floppy Iris Syndrome A systemic approach. J Cataract Refract Surg Today. 10:68–73. 2010.
14	Haridas A, Syrimi M, Al-Ahmar B and Hingorani M: Intraoperative floppy iris syndrome (IFIS) in patients receiving tamsulosin or doxazosin-a UK-based comparison of incidence and complication rates. Graefes Arch Clin Exp Ophthalmol. 251:1541–1555. 2013. View Article : Google Scholar : PubMed/NCBI
15	Cheung CM, Awan MA and Sandramouli S: Prevalence and clinical findings of tamsulosin-associated intraoperative floppy-iris syndrome. J Cataract Refract Surg. 32:1336–1339. 2006. View Article : Google Scholar : PubMed/NCBI
16	Schwinn DA and Afshari NA: Alpha (1)-Adrenergic receptor antagonists and the iris: New mechanistic insights into floppy iris syndrome. Surv Ophthalmol. 51:501–512. 2006. View Article : Google Scholar : PubMed/NCBI
17	Wong AC and Mak ST: Finasteride-associated cataract and intraoperative floppy-iris syndrome. J Cataract Refract Surg. 37:1351–1354. 2011. View Article : Google Scholar : PubMed/NCBI
18	Chatziralli IP, Sergentanis TN, Papazisis L and Moschos MM: Risk factors for intraoperative floppy iris syndrome: A retrospective study. Acta Ophthalmol. 90:e152–e153. 2012. View Article : Google Scholar : PubMed/NCBI
19	Pringle E and Packard R: Antipsychotic agent as an etiologic agent of IFIS. J Cataract Refract Surg. 31:2240–2241. 2015. View Article : Google Scholar
20	Unal M, Yücel I and Tenlik A: Intraoperative floppy-iris syndrome associated with chronic use of chloropromazine. Eye (Lond). 21:1241–1242. 2007. View Article : Google Scholar : PubMed/NCBI
21	Altiaylik Ozer P, Altiparmak UE, Unlu N, Hazirolan DO, Kasim R and Duman S: Intraoperative floppy-iris syndrome: Comparison of tamsulosin and drugs other than alpha antagonists. Curr Eye Res. 38:480–486. 2013. View Article : Google Scholar : PubMed/NCBI
22	Papadopoulos R and Bachariou A: Intraoperative floppy-iris syndrome associated with chronic intake of donepezil. J Cataract Refract Surg. 33:1997–1998. 2007. View Article : Google Scholar : PubMed/NCBI
23	Bilgin B, Ilhan D, Çetinkaya A and Ünal M: Intraoperative floppy iris syndrome associated with quetiapine. Eye (Lond). 27:6732013. View Article : Google Scholar : PubMed/NCBI
24	Ford RL, Sallam A and Towler HM: Intraoperative floppy iris syndrome associated with risperidone intake. Eur J Ophthalmol. 21:210–211. 2011. View Article : Google Scholar : PubMed/NCBI
25	Gupta A and Srinivasan R: Floppy iris syndrome with oral imipramine: A case series. Indian J Ophthalmol. 60:136–138. 2012. View Article : Google Scholar : PubMed/NCBI
26	González-Martín-Moro J, González-López JJ, Zarallo-Gallardo J and Fernández-Miguel Y: Intraoperative floppy iris syndrome after treatment with duloxetine: Coincidence, association, or causality? Arch Soc Esp Oftalmol. 90:94–96. 2015.(In Spanish). View Article : Google Scholar : PubMed/NCBI
27	Asensio-Sánchez VM: Intraoperative floppy iris syndrome and warfarin: Coincidence or side effect? Arch Soc Esp Oftalmol. 88:1602013.(In English, Spanish). View Article : Google Scholar : PubMed/NCBI
28	Neff KD, Sandoval HP, Fernández de Castro LE, Nowacki AS, Vroman DT and Solomon KD: Factors associated with intraoperative floppy iris syndrome. Ophthalmology. 116:658–663. 2009. View Article : Google Scholar : PubMed/NCBI
29	Yu Y and Koss MC: Studies of alfa adrenoreceptor antagonists on simpathetic in rabbits. J Ocul Pharmacol Ther. 19:255–263. 2003. View Article : Google Scholar : PubMed/NCBI
30	Hovanesian JA and Chang DF: State of the art: Intraoperative floppy iris syndrome. Ocular Surg News U.S. Edition. March 10–2008.