Intraoperative Management of Increased Intraocular Pressure in a Patient with Glaucoma Undergoing Robotic Prostatectomy in the Trendelenburg Position.
Patients with primary open angle glaucoma have decreased outflow through the trabecular meshwork of the eye, resulting in increased intraocular pressure (IOP). It is known that the Trendelenburg position causes increased IOP, but there are no current guidelines for monitoring and treating patients with glaucoma undergoing surgical procedures while in the Trendelenburg position. We describe a case of successful intraoperative management of increased IOP in a patient with glaucoma undergoing robotic radical prostatectomy while in steep Trendelenburg position.
From the *Department of Surgery, Virginia Tech Carilion School of Medicine, Roanoke, Virginia; †Department of Surgery, Edward Via College of Osteopathic Medicine, Virginia Campus, Blacksburg, Virginia; ‡Department of Anesthesiology, Anesthesiology Consultants of Virginia, Inc., Roanoke, Virginia; §Department of Urology, Jefferson Surgical Clinic, Inc., Roanoke, Virginia; and ∥Department of Ophthalmology, Vistar Eye Clinic, Roanoke, Virginia.
Maxine
M
Lee
Robert
R
Dallas
Charles
C
Daniel
Frank
F
Cotter
D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology; D018475:Head-Down Tilt / Q000009:adverse effects*; D006801:Humans; D007429:Intraocular Pressure; D007432:Intraoperative Period; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D012371:Robotics