Kan K M, Brown S E, Gainsburg D M
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA -
Minerva Anestesiol. 2015 May;81(5):557-66. Epub 2014 Jul 3.
Ocular complications reported after robotic-assisted laparoscopic radical prostatectomy (RALP) include corneal abrasion and ischemic optic neuropathy. While corneal abrasions often resolve without permanent sequelae, scarring or infection can occasionally lead to vision loss and other adverse outcomes. The rare complication of ischemic optic neuropathy leads to permanent vision loss and is a devastating outcome of non-ocular surgery. Given the unique patient positioning of steep Trendelenburg during these operations, ocular complications may be more likely to occur secondary to physiologic changes that occur within the eye itself. A review of the pathophysiology and incidence of ocular complications specific to robotic-assisted laparoscopic prostatectomy as well as the potential preventative measures in the current literature is presented to further inform and guide perioperative patient care. In addition we address other potential ocular complications and the impact of patient's ocular history on choice of RALP as a surgical treatment modality.
机器人辅助腹腔镜根治性前列腺切除术（RALP）后报告的眼部并发症包括角膜擦伤和缺血性视神经病变。虽然角膜擦伤通常可自行缓解且无永久性后遗症，但瘢痕形成或感染偶尔会导致视力丧失和其他不良后果。缺血性视神经病变这一罕见并发症会导致永久性视力丧失，是非眼部手术的灾难性后果。鉴于这些手术期间患者采取特伦德伦伯格卧位的独特体位，眼部并发症可能更易因眼内自身发生的生理变化而出现。本文对机器人辅助腹腔镜前列腺切除术特有的眼部并发症的病理生理学和发生率以及当前文献中的潜在预防措施进行综述，以进一步为围手术期患者护理提供信息并加以指导。此外，我们还讨论了其他潜在的眼部并发症以及患者眼部病史对选择RALP作为手术治疗方式的影响。
