Ocular Hypertension Clinical Trial
Official title:
Intraocular Pressure During Robotic Prostatectomy, Laparoscopic Surgery, and Open Exploratory Laparotomy
The purpose of this study is to measure pressures within the eye (during surgery to remove the prostate or abdominopelvic masses) as the body position required for these laparoscopic procedures has been associated with increases in pressure within the eye.
The National Cancer Institute estimates that 218,890 new cases of prostate cancer will have
been diagnosed in 2007. The three most commonly chosen options for localized prostate cancer
are radical prostatectomy (RP), external radiation therapy (XRT), and interstitial
brachytherapy (BT). A variety of surgical approaches are available, including open,
laparoscopic, and robotic prostatectomy. With the current trend towards "minimally invasive"
techniques, laparoscopic prostatectomy (LP) and, in particular, robotic assisted LP are on
the rise. Since gaining FDA approval in 2001, the robotic procedure has gained over 1/3 of
the market share. Preliminary data suggests this number may now have grown to over 50% of
all prostatectomies for cancer performed in the United States.
The minimally invasive procedures offer some advantages relative to the open alternative:
smaller incisions, improved pain control, decreased blood loss, and faster recovery have
been well documented. Cancer specific and quality of life (sexual function, continence)
outcomes will need more long term evaluation before definitive advantages with the minimally
invasive techniques are stated. Furthermore, there are potential risks with these minimally
invasive methods that have not been fully elucidated.
During a laparoscopic or robotic prostatectomy, patients are subjected to a marked
Trendelenberg position throughout the majority of the procedure. The effect of body
positioning has been shown previously to affect intraocular pressure (IOP). However, the
effect of surgical positioning on IOP during prostatectomies has not been well studied and
is not definitively known. Anecdotal reports of postoperative vision loss following robotic
assisted laparoscopic prostatectomy have surfaced thus further research is required to study
the effect that these procedures for prostate cancer may have on IOP and vision.
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