Our Summary

This research paper is about eye injuries that can occur during a specific type of prostate surgery known as robot-assisted laparoscopic prostatectomy (RALP). The researchers looked at various studies published between 2010 and 2023, focusing on those which had at least 100 men undergoing this surgery.

The main outcome they were looking at was the rate of eye injuries. They also looked at the type of eye problems, if they were permanent, the treatments used, risk factors, and ways to prevent these injuries. In total, they found nine studies that fit their criteria, covering a total of 100,872 men.

The most common injury was corneal abrasion (scratch on the eye’s surface), which was reported in six of the studies. The researchers combined the data from these studies and found the rate of this injury was about 5 in every 1000 surgeries. Three studies reported on other types of eye problems, including dry eyes and retinal vascular occlusion (blockage of the blood vessels in the eye), which affected 8, 5 and 2 men per 1000 surgeries respectively.

None of the studies reported permanent eye problems. However, the studies didn’t provide much information on how these injuries were treated. The researchers didn’t find any significant risk factors for these injuries. Interestingly, one of the studies suggested that African-American men were less likely to get corneal abrasion than others.

The study also mentioned some factors that could potentially increase the risk of corneal abrasion, such as the position of the patient during surgery, high pressure in the abdomen during the procedure, long surgery time, and lack of surgeon experience. On the other hand, using protective measures like eyelid dressings and foam goggles could decrease the rates of corneal abrasion.

In conclusion, the risk of eye injuries during RALP is low. However, doctors should make their patients aware of this possibility and use preventive measures to avoid such complications.

FAQs

  1. What is the incidence of ophthalmic injuries during robotic-assisted laparoscopic prostatectomy (RALP)?
  2. What are the risk factors for ophthalmic complications during RALP?
  3. What preventative measures can be implemented to reduce the rate of ophthalmic injuries during RALP?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostatectomy is to be aware of the potential risk of ophthalmic injuries during the procedure. They may recommend using occlusive eyelid dressings or foam goggles to reduce the risk of corneal abrasions, and to discuss any concerns or questions with their healthcare provider before the surgery.

Suitable For

Patients who are typically recommended prostatectomy are those with localized prostate cancer that has not spread beyond the prostate gland. Other factors that may influence the recommendation for prostatectomy include the patient’s age, overall health, and preferences for treatment.

Timeline

Before prostatectomy:

  • Patient is diagnosed with prostate cancer
  • Patient undergoes preoperative assessments, including imaging studies and blood tests
  • Patient discusses treatment options with their healthcare provider
  • Patient decides to undergo robotic-assisted laparoscopic prostatectomy (RALP)
  • Patient is scheduled for surgery and receives preoperative instructions

After prostatectomy:

  • Patient undergoes RALP procedure
  • Patient is monitored in the recovery room post-surgery
  • Patient is discharged from the hospital and receives postoperative instructions
  • Patient may experience side effects such as pain, urinary incontinence, and erectile dysfunction
  • Patient follows up with their healthcare provider for postoperative care and monitoring
  • Patient may require additional treatments or therapies depending on their recovery and any complications that arise.

What to Ask Your Doctor

  1. What are the potential risks and complications of ophthalmic injuries during prostatectomy?
  2. What preventative measures are in place to reduce the risk of ophthalmic injuries during the procedure?
  3. How common are ophthalmic injuries during prostatectomy, and what is the likelihood of permanent complications?
  4. What symptoms should I watch for post-surgery that may indicate an ophthalmic injury?
  5. What is the protocol for managing ophthalmic injuries if they occur during the procedure?
  6. Are there any specific risk factors that may increase the likelihood of ophthalmic injuries during prostatectomy?
  7. Are there any specific measures I can take before the surgery to reduce the risk of ophthalmic injuries?
  8. Will I be informed immediately if an ophthalmic injury occurs during the procedure?
  9. What follow-up care or monitoring will be required after the surgery to ensure there are no long-term effects on my vision?
  10. Are there any specific guidelines or recommendations for urologists to minimize the risk of ophthalmic injuries during prostatectomy?

Reference

Authors: Rabinowitz J, Kinnear N, O’Callaghan M, Hennessey D, Shafi F, Fuller A, Ibrahim M, Lane T, Adshead J, Vasdev N. Journal: J Robot Surg. 2024 Jan 19;18(1):46. doi: 10.1007/s11701-023-01771-z. PMID: 38240959