April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Positioning-Related Ocular Complications of Minimally-Invasive Radical Prostatectomies
Author Affiliations & Notes
  • Frank S Siringo
    Ophthalmology, University of Colorado School of Medicine, Denver, CO
    Ophthalmology, Columbia University College of Physicians and Surgeons, New York, NY
  • Timothy Wen
    Epidemiology, Columbia University Mailman School of Public Health, New York, NY
  • Christopher Diebert
    Urology, Columbia University College of Physicians and Surgeons, New York, NY
  • Benjamin Spencer
    Urology, Columbia University College of Physicians and Surgeons, New York, NY
    Epidemiology, Columbia University Mailman School of Public Health, New York, NY
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5574. doi:
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    • Get Citation

      Frank S Siringo, Timothy Wen, Christopher Diebert, Benjamin Spencer; Positioning-Related Ocular Complications of Minimally-Invasive Radical Prostatectomies. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5574.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To characterize positioning-related ocular complications of robotic-assisted radical prostatectomy, (RARP), compared to open radical prostatectomy (ORP), and laparascopic-assisted radical prostatectomy (LRP).

 
Methods
 

A retrospective study using 2008-09 discharge information data in the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (NIS). Patients diagnosed with prostate cancer undergoing ORP, LRP, or RARP were included. Outcome measures included a positioning-related complication, increased inpatient costs, prolonged length of stay, and in-hospital mortality. Chi-square, Fisher’s exact tests and multivariable logistic regression models compared groups and assessed associations between covariates and outcomes of interest.

 
Results
 

175,699 patients diagnosed with prostate cancer underwent radical prostatectomy in 2008-09; some 61,656 (35.1%) had RARP, 2,682 (1.5%) LRP, and 111,361 (63.4%) ORP. A total of 698 (0.4%) patients experienced a positioning complication. Ocular complications were most common, (51.1%), with non-significant differences in rates of 0.22% in ORP/LRP, vs 0.17% in RARP (p<0.110). Visually threatening ocular complication rates (retinal vascular occlusion, angle closure glaucoma, ischemic optic neuropathy, unilateral blindness) for ORP/LRP and RARP were 0.15% and 0.07%, respectively. The only significant hospital covariate was high annual RP case volume (>101 procedures), and it was protective (OR = 0.45, 95% CI: 0.27, 0.72, p-value = 0.0011).

 
Conclusions
 

This study is one of the first to assess positioning related ocular complications in a national population-based database. Despite prolonged steep trendelenburg positioning during RARP, vision-threatening ocular complications were more common in ORP/LRP. The primary limitation of the study was the use of administrative claims data, which lack detailed clinical information. However, the large national sample size increases the generalizability of our results.

  
Keywords: 462 clinical (human) or epidemiologic studies: outcomes/complications • 465 clinical (human) or epidemiologic studies: systems/equipment/techniques • 463 clinical (human) or epidemiologic studies: prevalence/incidence  
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