Ocular complications after open and hand-assisted laparoscopic donor nephrectomy.
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.
Koning
Jeffrey L
JL
Department of Urology, Loma Linda University Medical Center, Loma Linda, California, USA.
Nicolay
Lesli I
LI
Jellison
Forrest
F
Heldt
Jonathan P
JP
Dunbar
Jennifer A
JA
Baldwin
D Duane
DD
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