Does steep Trendelenburg positioning effect the ocular hemodynamics and intraocular pressure in patients undergoing robotic cystectomy and robotic prostatectomy?
OBJECTIVE
To examine the effect of steep Trendelenburg position (ST) on intraocular pressure (IOP), resistive index of the central retinal artery, and venous impedance index of the central retinal vein during robotic prostatectomy and cystectomy.


METHODS
A total of fifty-three male patients were included into the study (prostatectomy: 43, cystectomy: 10). During robotic surgery, the effect of the ST on IOP, resistive index of the central retinal artery (CRA-RI), and venous impedance index of the central retinal vein (CRV-VI) was prospectively examined. The measurement times of IOP are as follows: T1: before anesthesia while supine and awake; T2: anesthetized and supine; T3: anesthetized and ST; T4: anesthetized, ST, and intraperitoneal insufflation; T5: anesthetized in ST at the end of the procedure with CO2; T6: anesthetized in ST after desufflation; and T7: anesthetized supine before awakening.


RESULTS
There was no difference between the IOP values of the right and left eyes in both groups. The highest IOP values were reached at T4 and T5. CRA-RI values were different, while CRV-VI values were similar at T1 and T4.


CONCLUSIONS
Despite staying in the ST for a long time provided that the ophthalmologic examination was normal, ocular complication risk is low in robotic prostatectomy and cystectomy.
Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey. mfuatozcan@hotmail.com.
Muhammet Fuat
MF
Ozcan
Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Ziya
Z
Akbulut
Department of Ophthalmology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Canan
C
Gurdal
Department of Radiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Sinan
S
Tan
Department of Ophthalmology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Yelda
Y
Yildiz
Department of Ophthalmology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Serdar
S
Bayraktar
Department of Radiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Ayse Nur
AN
Ozcan
Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Kemal
K
Ener
Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Serkan
S
Altinova
Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Muhammed Ersagun
ME
Arslan
Department of Urology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey.
Mevlana Derya
MD
Balbay
D000368:Aged; D015653:Cystectomy; D018475:Head-Down Tilt / Q000502:physiology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D011468:Prostatectomy; D012161:Retinal Artery / Q000502:physiology; D012169:Retinal Vein / Q000502:physiology; D065287:Robotic Surgical Procedures; D013997:Time Factors; D014655:Vascular Resistance
Cystectomy; Intraocular pressure; Prostatectomy; Robotics; Trendelenburg position