Skip to main content
SpringerLink
Log in

Ocular Complications

  • Chapter
  • First Online:
Complications in Robotic Urologic Surgery

  • 757 Accesses

Abstract

Postoperative visual loss (POVL) is a rare but devastating complication that has been reported following a wide range of procedures including robotic urological surgery. Visual loss following elective non-ocular surgery is a catastrophic event for the patient, surgeon and anaesthetist. Despite being a rare entity, perioperative ocular complications in non-ophthalmic surgery have become a focus for surgical, anaesthetic and neuro-ophthalmological literature and a contentious medicolegal issue.

Ocular injuries associated with a degree of postoperative visual loss include a broad spectrum of conditions each with distinct aetiologies, risk factors, patterns of visual loss, treatment and prognoses. Injuries are categorized as corneal abrasion, retinal ischaemia, ischaemic optic neuropathy (ION), cortical blindness or acute glaucoma.

Procedures complicated with prolonged steep Trendelenburg positioning, significant blood loss, haemodynamic perturbations and prolonged pneumoperitoneum should be recognized as higher risk for POVL and visual assessment part of the postoperative assessment. When a patient reports any visual symptoms following surgery, an urgent ophthalmologic consultation should be obtained to determine its cause.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Olympio M. Postoperative visual loss after robotic pelvic surgery. BJU Int. 2013;112(8):1464–410x.

    Article  Google Scholar 

  2. Pinkney TD, King AJ, Walter C, Wilson TR, Maxwell-Armstrong C, Acheson AG. Raised intraocular pressure (IOP) and perioperative visual loss in laparoscopic colorectal surgery: a catastrophe waiting to happen? A systematic review of evidence from other surgical specialities. Tech Coloproctol. 2012;16(5):331–5.

    Article  CAS  PubMed  Google Scholar 

  3. Newman N. Perioperative visual loss after nonocular surgeries. Am J Ophthalmol. 2008;145(5):604–10.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Roth S. Postoperative visual loss. In: Miller RD, editor. Miller’s anesthesia. 8th ed. New York: Elsevier; 2014. p. 3011–32.

    Google Scholar 

  5. American Society of Anesthesiologists Task Force on Perioperative Blindness. Practice advisory for perioperative visual loss associated with spine surgery: a report by the American Society of Anesthesiologists Task Force on perioperative blindness. Anesthesiology. 2006;104:1319–28.

    Article  Google Scholar 

  6. Nickels TJ, Manlapaz MR, Farag E. Perioperative visual loss after spine surgery. World J Orthop. 2014;5(2):100–6. doi:10.5312/wjo.v5.i2.100.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Segal KL, Fleischut PM, Kim C, et al. Evaluation and treatment of perioperative corneal abrasions. J Ophthal. 2014;2014:79–84.

    Article  Google Scholar 

  8. Fraser S. Corneal abrasion. Clin Ophthal. 2010;4:387–90.

    Article  Google Scholar 

  9. American Society of Anesthesiologists Task Force on Perioperative Visual Loss. Practice advisory for perioperative visual loss associated with spine surgery: an updated report by the American Society of Anesthesiologists Task Force on perioperative visual loss. Anesthesiology. 2012;116:274–85.

    Article  Google Scholar 

  10. White E, Crosse MM. The aetiology and prevention of peri-operative corneal abrasions. Anaesthesia. 1998;53(2):157–61.

    Article  CAS  PubMed  Google Scholar 

  11. Roth S, Thisted RA, Erickson JP, Black S, Schreider BD. Eye injuries after nonocular surgery: a study of 60,965 anesthetics from 1988 to 1992. Anesthesiology. 1996;85(5):1020–7.

    Article  CAS  PubMed  Google Scholar 

  12. Stambough JL, Dolan D, Werner R, Godfrey E. Ophthalmologic complications associated with prone positioning in spine surgery. J Am Acad Orthop Surg. 2007;15:156–65.

    Article  PubMed  Google Scholar 

  13. Grover VK, Kumar KV, Sharma S, Sethi N, Grewal SP. Comparison of methods of eye protection under general anaesthesia. Can J Anaesth. 1998;45:575–7.

    Article  CAS  PubMed  Google Scholar 

  14. Roth S. Perioperative visual loss: what do we know, what can we do? Br J Anaesth. 2009;103(1):i31–40.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ettaiche M, Heurteaux C, Blondeau N, Borsotto M, Tinel N, Lazdunski M. ATP-sensitive potassium in the retina: a key role in delayed ischaemic tolerance. Brain Res. 2001;890:118–29.

    Article  CAS  PubMed  Google Scholar 

  16. Hollenhorst RW, Svien HJ, Benoit CF. Unilateral blindness occurring during anesthesia for neurosurgical operations. AMA Arch Ophthalmol. 1954;52(6):819–30.

    Article  CAS  PubMed  Google Scholar 

  17. Leibovitch I, Casson R, Laforest C, Selva D. Ischemic orbital compartment syndrome as a complication of spinal surgery in the prone position. Ophthalmology. 2006;113(1):105–8.

    Article  PubMed  Google Scholar 

  18. Grover V, Jangra K. Perioperative vision loss: a complication to watch out. J Anaesthesiol Clin Pharmacol. 2012;28(1):11–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Kumar N, Jivan S, Topping N, Morrell AJ. Blindness and rectus muscle damage following spinal surgery. Am J Ophthalmol. 2004;138(5):889–91.

    Article  PubMed  Google Scholar 

  20. Katz DA, Karlin LI. Visual field defect after posterior spine fusion. Spine. 2005;30:83–5.

    Article  Google Scholar 

  21. Lee MS, Grossman D, Arnold AC, Sloan FA. Incidence of nonarteritic anterior ischemic optic neuropathy: increased risk among diabetic patients. Ophthalmology. 2011;118(5):959–63.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ho VT, Newman NJ, Song S, Ksiazek S, Roth S. Ischemic optic neuropathy following spine surgery. J Neurosurg Anesthesiol. 2005;17(1):38–44.

    PubMed  PubMed Central  Google Scholar 

  23. Kirkali P, Kansu T. A case of unilateral posterior ischemic optic neuropathy after radical neck dissection. Ann Ophthalmol. 1990;22(8):297–8.

    CAS  PubMed  Google Scholar 

  24. Schobel GA, Schmidbauer M, Millesi W, Undt G. Posterior ischemic optic neuropathy following bilateral radical neck dissection. Int J Oral Maxillofac Surg. 1995;24(4):283–7.

    Article  CAS  PubMed  Google Scholar 

  25. Lee LA. Visual loss, venous congestion and robotic prostatectomies. ASA Newsl. 2011;75:26–7.

    Google Scholar 

  26. The Postoperative Visual Loss Study Group. Risk factors associated with ischemic optic neuropathy and spinal fusion surgery. Anesthesiology. 2012;116:15–24.

    Google Scholar 

  27. Dunker S, Hsu HY, Sebag J, Sadun AA. Perioperative risk factors for posterior ischemic optic neuropathy. J Am Coll Surg. 2002;194(6):705–10.

    Article  PubMed  Google Scholar 

  28. Roth S, Gillesberg I. Injuries to the visual system and other sense organs. In: Benumof JL, Saidman LJ, editors. Anaesthesia and perioperative complications. St Loius: Mosby; 1999. p. 377–408.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Urology Department, Guys & St Thomas’ NHS Trust, Great Maze Pond, London, SE1 9RT, UK

    Rick Catterwell MBBS, FRACS (Urol) & G. Blecher MBBS, FRACS (Urol)

  2. Urology Department, King’s College London, Mail via Guys & St Thomas’ NHS Trust, Great Maze Pond, London, SE1 9RT, UK

    Rick Catterwell MBBS, FRACS (Urol) & P. Dasgupta MSc, MD, FRCS (Urol), FEBU

  3. Department of Urology, Guys & St Thomas’ Trust/King’s College Hospital, Great Maze Pond, London, SE1 9RT, UK

    Rick Catterwell MBBS, FRACS (Urol)

  4. Department of Anaesthesia, Guys & St Thomas’ NHS Trust, Great Maze Pond, London, SE1 9RT, UK

    Emad Aziz Girgis MBBS, FRCA

Authors
  1. Rick Catterwell MBBS, FRACS (Urol)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emad Aziz Girgis MBBS, FRCA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Blecher MBBS, FRACS (Urol)
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Dasgupta MSc, MD, FRCS (Urol), FEBU
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rick Catterwell MBBS, FRACS (Urol) .

Editor information

Editors and Affiliations

  1. USC Institute of Urology, University of Southern California, Los Angeles, California, USA

    René Sotelo

  2. Department of Urology, Hospital CIMA, Hermosillo, Sonora, Mexico

    Juan Arriaga

  3. USC Institute of Urology, University of Southern California, Los Angeles, California, USA

    Monish Aron

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Catterwell, R., Girgis, E.A., Blecher, G., Dasgupta, P. (2018). Ocular Complications. In: Sotelo, R., Arriaga, J., Aron, M. (eds) Complications in Robotic Urologic Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-62277-4_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-62277-4_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-62276-7

  • Online ISBN: 978-3-319-62277-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation