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Intraoperative complications during phacoemulsification in patients with systemic Alpha-1 blockers

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Session Details

Session Title: Presented Poster Session: Cataract Complications Management

Venue: Poster Village: Pod 1

First Author: : T.Fredriksson SWEDEN

Co Author(s): :    M. Zetterberg              

Abstract Details


To evaluate complications occurring during cataract surgery in patients with a history of systemic Alpha-1 blocker use.


Department of Ophthalmology, Sahlgrenska University Hospital, Sweden.


A total of 1729 patients were included in a retrospective study. Data was collected on age, gender and use of Alpha-1 blockers. Also, preoperative data on pupil diameter and pseudoexfoliations (PEX) were retrieved, as well as intraoperative adverse events, such as pupillary constriction, iris billowing, iris prolapse and posterior capsule rupture.


Using logistic binary regression including age, PEX and use of Alpha-1 blockers were significantly associated with smaller pupils; adjusted Odds ratio [aOR] for Alpha-1 blockers was 2.61 (95% CI 1.52-4.47, p<0.001) and for PEX aOR 2.54 (95% CI 1.71-3.79, p<0.000). PEX and age were associated with mechanical pupil dilation; aOR 5.02 (95% CI 2.82-8.95, p<0.000) and aOR 1.08 (95% CI 1.05-1.12, p<0.000) respectively. No significant associations were seen between Alpha-1 blocker use or PEX and iris billowing or iris prolapse. Age was the only significant risk factor for posterior capsule rupture 1.08 (95% CI 1.02-1.13, p=0.004).


Both alpha-1 blockers and PEX were associated with smaller pupils preoperatively but only PEX was associated with mechanical pupil dilation, indicating that PEX is a stronger risk factor for intraoperative pupil constriction than alpha-1 blockers. However, neither alpha-1 blockers nor PEX resulted in more intraoperative complications. High age was associated with both mechanical pupil dilation and posterior capsule rupture.

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