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Tamsulosin and Ophthalmic Adverse Events After Cataract Surgery

Sergio Ponce-de-Leon, MD
JAMA. 2009;302(10):1054-1055. doi:10.1001/jama.2009.1285
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To the Editor: In the study of the association between tamsulosin and ophthalmic adverse events following cataract surgery by Dr Bell and colleagues,1 I believe there is a contradiction between the results as presented in the abstract and in the body of the article. The abstract states, “Adverse events were significantly more common among patients with recent tamsulosin exposure (7.5% vs 2.7%; adjusted odds ratio [OR], 2.33; 95% confidence interval [CI], 1.22-4.43). . . . ” This suggests a comparison of measurement of adverse outcomes between exposed vs nonexposed patients.

However, the nested case-control design of the study does not allow such an inference. As correctly stated in the “Results” section of the article, “In our primary analysis of adverse events following cataract surgery, 21 case patients (7.5%) and 30 control patients (2.7%) received tamsulosin in the 14 days before surgery. This resulted in an adjusted OR of 2.33 (95% CI, 1.22-4.43 . . . )”.

When considering the actual incidence of adverse outcomes, the correct rates would be 6.9 per 1000 persons using tamsulosin vs 3 per 1000 persons not using tamsulosin, based on estimates of absolute risk found by the authors. This is a very different interpretation.

AUTHOR INFORMATION

Financial Disclosures: None reported.

REFERENCES

Bell CM, Hatch WV, Fischer HD,  et al.  Association between tamsulosin and serious ophthalmic adverse events in older men following cataract surgery.  JAMA. 2009;301(19):1991-1996
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Bell CM, Hatch WV, Fischer HD,  et al.  Association between tamsulosin and serious ophthalmic adverse events in older men following cataract surgery.  JAMA. 2009;301(19):1991-1996
PubMedCrossRef
September 9, 2009
Bruce I. Gaynes, OD, PharmD
JAMA. 2009;302(10):1054-1055.
September 9, 2009
Chaim Bell, MD, PhD; Andrea Gruneir, PhD; Paula Rochon, MD, MPH
JAMA. 2009;302(10):1054-1055.
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