Elsevier

American Journal of Ophthalmology

Volume 158, Issue 6, December 2014, Pages 1215-1220.e1
American Journal of Ophthalmology

Original article
Wound Dehiscence as a Cataract Surgery–Associated Postoperative Complication in Patients Previously Treated With Alpha-1 Blocker Tamsulosin—A Population-Based Study in Taiwan

https://doi.org/10.1016/j.ajo.2014.08.022Get rights and content

Purpose

To compare the cataract surgery–related complications between patients with and without tamsulosin treatment.

Design

A nationwide retrospective case-control study.

Methods

Patients who had undergone cataract surgery were identified using the International Classification of Disease, Ninth Revision, Clinical Modification from a nationally representative dataset of 1 million people selected from the Taiwan National Health Insurance Research Database in 2000. Patients preoperatively treated with α1-blockers before cataract surgery were the treated group, and age-, sex-, and year of surgery–matched patients not preoperatively treated with α1-blockers were the control group. Patients treated with tamsulosin underwent subgroup analysis. A conditional logistic regression model was used to estimate surgery-related complications and interesting variables. The main outcome measures are cataract surgery–related complications.

Results

A total of 4474 treated patients and 4474 controls were analyzed. The percentage of cataract surgery–related complications was 8.61% in the treated group and 8% in the control group (not significantly different). However, wound dehiscence was 3.81 times higher (95% confidence interval: 1.24–11.67, P = .0194) in the tamsulosin-treated group.

Conclusions

Patients treated with tamsulosin have a higher risk of wound dehiscence after cataract surgery. Carefully taking a history of tamsulosin use before cataract surgery is advised so that some strategies can be used to prevent complications and additional costs.

Section snippets

Methods

Taiwan's nationwide National Health Insurance Research Database (NHIRD) was the data source for this retrospective case-control study. We estimated the risk of patients who had undergone cataract surgery with and without preoperative α1-blocker treatment. Taiwan's National Health Insurance program began in 1995, and approximately 99% of the population is currently enrolled in the program.6, 7 Personal information is confidential because patient identification numbers and other sensitive

Results

We identified 23 873 patients who had undergone cataract surgery. After age, sex, and year of surgery matching, we enrolled 8948 patients: 4474 had taken an α1-blocker and 4474 had not. Patients who had taken an α1-blocker lived in areas with a higher level of urbanization and had more hypertension and diabetes mellitus (Table 1).

The number of patients with at least 1 cataract surgery–related complication was not significantly different between the α1-Blocker group (385 [8.61%]) and the No α1

Discussion

We found that the incidence of cataract surgery–related complications was not significantly different between patients who had and had not taken α1-blockers before surgery. The most common cataract surgery–related complications were glaucoma and a dropped nucleus in all groups. Patients who took tamsulosin had 3.81 times more wound dehiscence than did patients who had not taken α1-blockers before surgery.

There are few published articles on cataract surgery–related complications in patients who

Ching-Hsing Hsiao MD, is the director of Ophthalmology in Chi Mei Hospital, Chia Li in Taiwan. He graduated from Chung Shan Medical University and completed his Ophthalmology residency in National Cheng Kung University Hospital,Taiwan. He has interest in cataract and refractive surgery.

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Ching-Hsing Hsiao MD, is the director of Ophthalmology in Chi Mei Hospital, Chia Li in Taiwan. He graduated from Chung Shan Medical University and completed his Ophthalmology residency in National Cheng Kung University Hospital,Taiwan. He has interest in cataract and refractive surgery.

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