title: Ocular complications after open and hand-assisted laparoscopic donor nephrectomy.
abstract: OBJECTIVE
  To compare the incidence of ocular complications (OC) and corneal abrasion (CA) after hand-assisted laparoscopic donor nephrectomy (HALDN) and open donor nephrectomy (ODN).
  
  
  METHODS
  A retrospective review was conducted of 241 consecutive patients (141 HALDN and 100 ODN) over a 9-year period. OC were strictly defined as ocular complaints requiring any treatment or ophthalmologic consultation. Chi-square tests were used to compare the incidence of OC and CA by type of surgery.
  
  
  RESULTS
  OC were observed in 9 HALDN patients (6.4%) and no ODN patients (0%; P = .01). All OC in HALDN patients involved the dependent eye (P <.001). CA occurred in 2 HALDN patients (1.4%) compared with no ODN patients (0%; P = .23). HALDN patients had significantly higher net fluid intake than the ODN patients (P <.01).
  
  
  CONCLUSIONS
  The increased OC and CA seen in HALDN patients may result from the increased fluid intake, flank positioning, and potential increased venous compression resulting from the effects of the pneumoperitoneum. The fact that the dependent eye was involved in all patients suggests conjunctival edema as a potential common pathway. The high frequency of OC suggests the importance of techniques to minimize OC after HALDN.
authors.affiliation: Department of Urology, Loma Linda University Medical Center, Loma Linda, California, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Koning
authors.forename: Lesli I
authors.initials: LI
authors.lastname: Nicolay
authors.forename: Forrest
authors.initials: F
authors.lastname: Jellison
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Heldt
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Dunbar
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
mesh_terms: D000328:Adult; D003316:Corneal Diseases / Q000453:epidemiology / Q000209:etiology; D005128:Eye Diseases / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D014019:Tissue Donors