Postoperative Patient-Reported Visual Symptoms After Robot-Assisted Laparoscopic Radical Prostatectomy in Steep...

Area of Science:

• Ophthalmology
• Neurosurgery
• Medical Technology

Background:

• Robot-assisted laparoscopic radical prostatectomy (RALP) involves steep Trendelenburg positioning, increasing intraocular and intracranial pressure.
• While objective visual field defects are known, patient-reported visual outcomes after RALP are not well-documented.
• This study investigates the association between intraoperative optic nerve sheath diameter (ONSD) and hemodynamic variables with patient-reported visual symptoms post-RALP.

Purpose of the Study:

• To determine the incidence of patient-reported visual symptoms after RALP.
• To explore the relationship between intraoperative ONSD and hemodynamic parameters with postoperative visual complaints.
• To assess the utility of Rasch analysis for quantifying visual outcomes.

Main Methods:

• Prospective, single-center observational cohort study of 55 patients undergoing RALP.
• Intraoperative ONSD measured via transorbital ultrasound at three time points.
• Postoperative visual symptoms assessed using the Catquest-9SF questionnaire and analyzed with Rasch analysis.

Main Results:

• 10.9% of patients reported new subjective visual symptoms post-RALP.
• Rasch-transformed visual function scores were significantly associated with the presence of visual symptoms (p < 0.05).
• Neither lowest mean arterial pressure nor maximum ONSD reached statistical significance as independent predictors of visual symptoms.

Conclusions:

• Approximately 11% of patients experience visual symptoms after RALP.
• Postoperative visual function scores correlate with patient-reported visual complaints.
• Further research is needed to investigate the role of intraoperative hypotension in larger cohorts.