To ascertain the angular threshold and primary determinants affecting intraocular pressure (IOP) increase during robot-assisted radical prostatectomy (RARP) in the Trendelenburg position.
Key Findings:
The ideal Trendelenburg angle threshold for increased IOP was found to be 20.5°.
Angles ≥20.5° were significantly correlated with raised IOP (P = 0.001).
Patients with diabetes had a higher risk of IOP elevation (P = 0.028).
The predictive model for elevated IOP had an AUC of 0.721 (95% CI: 0.621–0.820).
Interpretation:
More pronounced Trendelenburg positioning (≥20.5°), leg angles (≥9.5°), and a history of diabetes are independent risk factors for intraoperative IOP elevation during RARP.
Limitations:
Study limited to a single institution which may affect generalizability.
Sample size may limit the robustness of the predictive model.
Conclusion:
Tailored patient positioning is crucial to minimize ocular complications, advocating for less extreme angles in high-risk individuals.
