Effect of Trendelenburg positioning during Robot-assisted laparoscopic radical prostatectomy (RALP) on IOP and visual function

Abstract

Purpose : To evaluate the effects of Trendelenburg positioning during RALP on IOP and visual function.

Methods : The study group consisted of 128 eyes from 64 male patients who underwent RALP at the University of Tokyo Hospital between December 2015 to October 2016. Best corrected visual acuity (BCVA), IOP, axial length measurement and Humphrey visual field analyzer (HFA) 30-2 program visual field testing were scheduled before and 1 week after surgery. Operation time and IOP change over time were also measured.

Results : The mean age is 66.3±5.3 year old. The average operation time was 3.6±1.0 hours. The IOP immediately after anesthesia induction was11.0±2.7mmHg (OD) and 11.0±2.8mmHg (OS). The highest IOP measured during operation was 24.4±4.5mmHg (OD) and 24.6±4.5mmHg (OS). Each was significantly elevated compared with that measured immediately after anesthesia induction, respectively (p<0.001). The increasing range of IOP during operation was neither correlative with operation time nor with axial length. There was no change between the preoperative and postoperative visual acuity. The MD (mean deviation) values of HFA including 15 glaucoma eyes of 9 patients revealed no post-operative MD value decrease more than 2 dB.

Conclusions : Trendelenburg positioning in RALP induced IOP elevation during operation but had no effect on post-operative visual function.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.