Effects of robot-assisted laparoscopic radical prostatectomy on normal and glaucomatous eyes

Abstract We evaluated intraocular pressure (IOP) changes in normal and glaucomatous eyes during robot-assisted laparoscopic radical prostatectomy (RARP) and the effects on visual function. We enrolled 52 patients with normal eyes and 12 patients with glaucoma who underwent RARP. IOP increased during Trendelenburg positioning. IOP under anesthesia in a steep Trendelenburg position at the end of the procedure was 29.4 ± 7.7 mmHg in normal eyes and 31.2 ± 5.2 mmHg in glaucomatous eyes. IOP returned to the level at the beginning of the operation when the patient was returned to the supine position. Mean IOP for each time point was similar in normal and glaucomatous eyes. None of the patients with normal eyes experienced the onset of glaucoma postoperatively. None of the patients with glaucomatous eyes had progression as assessed with optical coherence tomography and visual field tests up to 12 months after RARP. RARP appears to have little or no effect on the subsequent progression of glaucoma. Though it is certain that IOP increases during surgery, RARP might be considered acceptable for patients with mild to moderate stage of glaucoma.