AUA 2018: Prospective Evaluation of Effect on Intraocular Pressure and Visual Function in Patients Without and with Ophthalmic Diseases after Robotic Assisted Laparoscopic Prostatectomy

San Francisco, CA ( In this abstract Shigenori Kakutani, MD discussed ophthalmic changes from robotic-assisted laparoscopic prostatectomy.  Previous publications have demonstrated the increase in intraocular pressure from the steep Trendelenburg position with subsequent concerns over the potential postoperative visual loss.  Few data have investigated ophthalmic disease following prostatectomy specifically. 

The group performed a prospective analysis from 2015-2017 of patients undergoing prostatectomy where intraocular pressure was measured before, during, and after prostatectomy.  They defined the mean defect change over -2dB as post-operative visual loss.

98 patients were included in the analysis, and these were stratified by preoperative presence of glaucoma, with a median age of 66 years.  Intraocular pressure was significantly increased during Trendelenburg positioning; however, no statistical differences was noted in mean defect values before and after robotic prostatectomy.  At 7 days postoperatively, 3 subjects were diagnosed with ophthalmic diseases including normal tension glaucoma, epiretinal membrane, and scleritis. 

In conclusion, Katani explained that intraocular pressure was significantly increased during robotic prostatectomy.  None of the patients had severe visual loss in the 3 months following surgery in patients with ophthalmic disease.  Finally, this study indicated that robotic prostatectomy does not alter visual function in the long term even in patients with normal tension glaucoma.

Presented by: Shigenori Kakutani, MD, Mitsui Memorial Hospital, Department of Urology, Graduate School of Medicine, The University of Tokyo
Co-Authors: Hiroshi Fukuhara, Fumiyuki Araki, Masaaki Asamoto, Nobuko Ito, Makoto Aihara, Haruki Kume, Tokyo, Japan

Written by:  David B. Cahn, DO, MBS Fox Chase Cancer Center Philadelphia, PA @dbcahn at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA
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