Two patients developed postoperative ischemic optic neuropathy (ION) after laparoscopic radical prostatectomy. One operation was robotically assisted; the other was performed with the conventional laparoscopic technique. These new minimally invasive techniques offer many advantages, but they require steep supine head-flexed (Trendelenburg) positioning. Until they are mastered by surgeons, operative times may be prolonged beyond those associated with the traditional technique. As a result, ION may occur more frequently.