Skip to main content

Advertisement

SpringerLink
Log in

Intraocular pressure change during laparoscopic sacral colpopexy in patients with normal tension glaucoma

  • Original Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

The steep Trendelenburg position, high pneumoperitoneum pressure, and longer surgical time may lead to significantly increased intraocular pressure (IOP), which could result in unexpected eye disease complications, including perioperative visual loss (POVL). We monitored IOP to induce early laparoscopic sacral colpopexy (LSC) safely.

Methods

This prospective study enrolled 39 patients with pelvic organ prolapse (POP), including 10 with eye diseases (6 with normal tension glaucoma and 4 with a narrow anterior chamber and normal range IOP). Enrolled patients underwent LSC under the same surgical settings involving a pneumoperitoneum of 10 mmHg and a Trendelenburg position of 15°. We measured IOP at seven time points during surgery and estimated IOP changes with time in patients with or without eye diseases.

Results

All patients, with or without eye diseases, experienced significantly elevated IOP during LSC. There were no significant differences between these groups. The average maximal IOP reached 20 mmHg at the end of surgery, and recovered to baseline values with the patient in the supine position at the end of anesthesia. No patient had an IOP of >40 mmHg as a critical threshold during surgery, and no substantial clinical eye symptoms were seen after LSC.

Conclusions

Laparoscopic sacral colpopexy using an pneumoperitoneum of 10 mmHg and a Trendelenburg position of 15° during a 3-h surgical period could be performed within a safe range of IOP.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

IOP:

Intraocular pressure

LSC:

Laparoscopic sacral colpopexy

NAC:

Narrow anterior chamber angle

NTG:

Normal tension glaucoma

POP:

Pelvic organ prolapse

POP-Q:

Pelvic organ prolapse quantification

POVL:

Perioperative visual loss

RALP:

Robot-assisted laparoscopic radical prostatectomy

References

  1. Ganatra AM, Rozet F, Sanchez-Salas R, Barret E, Galiano M, Cathelineau X, et al. The current status of laparoscopic sacrocolpopexy: a review. Eur Urol. 2009;55(5):1089–105.

    Article  Google Scholar 

  2. Maher CF, Feiner B, DeCuyper EM, Nichlos CJ, Hickey KV, O’Rourke P. Laparoscopic sacral colpopexy versus total vaginal mesh for vaginal vault prolapse: a randomized trial. Am J Obstet Gynecol. 2011;204(4):360.e1–7.

    Article  Google Scholar 

  3. Gabriel B, Nassif J, Barata S, Wattiez A. Twenty years of laparoscopic sacrocolpopexy: where are we now? Int Urogynecol J. 2011;22(9):1165–9.

    Article  Google Scholar 

  4. Weber ED, Colyer MH, Lesser RL, Subramanian PS. Posterior ischemic optic neuropathy after minimally invasive prostatectomy. J Neuroophthalmol. 2007;27:285–7.

    Article  Google Scholar 

  5. Bui BV, Edmunds B, Cioffi GA, Fortune B. The gradient of retinal functional changes during acute intraocular pressure elevation. Invest Ophthalmol Vis Sci. 2005;46:202–13.

    Article  Google Scholar 

  6. Awad H, Santilli S, Ohr M, Roth A, Yan W, Fernandez S, et al. The effects of steep Trendelenburg positioning on intraocular pressure during robotic radical prostatectomy. Anesth Analg. 2009;109(2):473–8.

    Article  Google Scholar 

  7. Molloy BL. Implications for postoperative visual loss: steep Trendelenburg position and effects on intraocular pressure. AANA J. 2011;79:115–21.

    PubMed  Google Scholar 

  8. Taketani Y, Mayama C, Suzuki N, Wada A, Oka T, Inamochi K, et al. Transient but significant visual field defects after robot-assisted laparoscopic radical prostatectomy in deep Trendelenburg position. PLoS One. 2015;10(4):e0123361.

    Article  Google Scholar 

  9. Hoshikawa Y, Tsutsumi N, Ohkoshi K, Serizawa S, Hamada M, Inagaki K, et al. The effect of steep Trendelenburg positioning on intraocular pressure and visual function during robotic-assisted radical prostatectomy. Br J Ophthalmol. 2014;98(3):305–8.

    Article  Google Scholar 

  10. Iwase A, Suzuki Y, Araie M, Yamamoto T, Abe H, Shirato S, et al. The prevalence of primary open-angle glaucoma in Japanese: the Tajimi study. Ophthalmology. 2004;111:1641–8.

    PubMed  Google Scholar 

  11. Yamamoto T, Iwase A, Araie M, Suzuki Y, Abe H, Shirato S, et al. The Tajimi study report 2: prevalence of primary angle closure and secondary glaucoma in a Japanese population. Ophthalmology. 2005;112:1661–9.

    Article  Google Scholar 

  12. Kla KM, Lee LA. Perioperative visual loss. Best Pract Res Clin Anaesthesiol. 2016;30:69–77.

    Article  Google Scholar 

  13. American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on acute pain management. Anesthesiology. 2012;116:248–73.

    Article  Google Scholar 

  14. Wattiez A, Boughizane S, Alexandre F, Canis M, Mage G, Pouly JL, et al. Laparoscopic procedures for stress incontinence and prolapse. Curr Opin Obstet Gynecol. 1995;7:317–21.

    Article  CAS  Google Scholar 

  15. Vandendriessche D, Sussfeld J, Giraudet G, Lucot JP, Behal H, Cosson M. Complications and reoperations after laparoscopic sacrocolpopexy with a mean follow-up of 4 years. Int Urogynecol J. 2017;28:231–9.

    Article  Google Scholar 

  16. 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  Google Scholar 

  17. Shen Y, Drum M, Roth S. The prevalence of perioperative visual loss in the United States: a 10-year study from 1996 to 2005 of spinal, orthopedic, cardiac, and general surgery. Anesth Analg. 2009;109:1534–45.

    Article  Google Scholar 

  18. Stoffelns BM. Decreased visual acuity and loss of field of vision after inguinal hernia surgery. Ophthalmologe. 2009;106:448–51.

    Article  CAS  Google Scholar 

  19. Mizrahi H, Hugkulstone CE, Vyakarnam P, Parker MC. Bilateral ischaemic optic neuropathy following laparoscopic proctocolectomy: a case report. Ann R Coll Surg Engl. 2011;93:e53–4.

    Article  CAS  Google Scholar 

  20. Molloy B. A preventive intervention for rising intraocular pressure: development of the Molloy/Bridgeport anesthesia associates observation scale. AANA J. 2012;80(3):213–22.

    PubMed  Google Scholar 

  21. Grosso A, Scozzari G, Bert F, Mabilia MA, Siliquini R, Morino M. Intraocular pressure variation during colorectal laparoscopic surgery: standard pneumoperitoneum leads to reversible elevation in intraocular pressure. Surg Endosc. 2013;27(9):3370–6.

    Article  Google Scholar 

  22. Lentschener C, Benhamou D, Niessen F, Mercier FJ, Fernandez H. Intra-ocular pressure changes during gynaecological laparoscopy. Anaesthesia. 1996;51(12):1106–8.

    Article  CAS  Google Scholar 

  23. Hitchings RA. Low tension glaucoma—its place in modern glaucoma practice. Br J Ophthalmol. 1992;76:494–6.

    Article  CAS  Google Scholar 

  24. Molloy B, Watson C. A comparative assessment of intraocular pressure in prolonged steep Trendelenburg position versus level supine position intervention. J Anesthesiol Clin Sci. 2012;1(9):8. https://doi.org/10.7243/2049-9752-1-9.

    Article  Google Scholar 

  25. Shihota R, Dada T, Gupta V, Deepak KK, Pandey RM. Narrowing of the anterior chamber angle during Valsalva maneuver: a possible mechanism for angle closure. Eur J Ophthalmol. 2006;16(1):81–91.

    Article  Google Scholar 

Download references

Acknowledgements

This study won the academic award of the poster presentation at the 11th Japanese Society of POP Surgery (JPOP) annual scientific meeting, 11–12 March 2017, Tokyo, Japan.

The authors acknowledge and thank the following mentors and advisors: Seiichi Era, Hidetoshi Ehara, Hiroki Ito.

Author information

Authors and Affiliations

  1. Department of Urology and Urogynecology Center, Japanese Red Cross Gifu Hospital, 3-36 Iwakura-cho, Gifu City, 502-8511, Japan

    Yoji Moriyama & Kosei Miwa

  2. Department of Anesthesia, Japanese Red Cross Gifu Hospital, Gifu, Japan

    Tadanori Yamada

  3. Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan

    Ayako Sawaki

  4. Nishino-Clinic, Gifu, Japan

    Yoshinori Nishino

  5. Department of Urology, Komatsu Municipal Hospital, Ishikawa, Japan

    Yasuhide Kitagawa

Authors
  1. Yoji Moriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kosei Miwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tadanori Yamada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayako Sawaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshinori Nishino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasuhide Kitagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoji Moriyama.

Ethics declarations

Conflicts of interest

None.

Financial support

None.

Patient consent

Written consent was obtained from the patients included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moriyama, Y., Miwa, K., Yamada, T. et al. Intraocular pressure change during laparoscopic sacral colpopexy in patients with normal tension glaucoma. Int Urogynecol J 30, 1933–1938 (2019). https://doi.org/10.1007/s00192-018-03866-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-018-03866-w

Keywords

Search

Navigation