Effect of haemodialysis on intraocular pressure

Abstract

Aims To study the effect of haemodialysis on intraocular pressure (IOP) of patients at the University Malaya Medical Centre, Kuala Lumpur, and the influence of anterior chamber angles, surgery, and diabetes on the change in IOP after haemodialysis. Methods Prospective, single centre study on patients undergoing haemodialysis with a sample size of 98 eyes (49 patients). Ocular examination was performed before haemodialysis. Pre-and post-haemodialysis IOP measurements were taken. Plasma osmolarity changes and volume of fluid removed were noted. Patients on antiglaucoma treatment or who have had earlier laser or surgical procedures for it were excluded. Student's t-test and Pearson's coefficient test were used to determine the statistical significance. Results Plasma osmolarity decreased significantly (À11.6 ± 10.0mOsm/l, Po0.001). In eyes with occludable angles (8% of cases), IOP decreased significantly (À3.63 ± 1.92 mmHg, Po0.001). In non-occludable angle eyes (92% of cases), no significant changes (P40.05) in all subgroups of non-operated/operated and diabetic/ non-diabetic eyes were seen. Conclusions Haemodialysis does not cause significant changes in IOP in non-glaucomatous and non-occludable angle eyes.

The effect of hemodialysis on intraocular pressure

“…17 The removal of water during HD decreases plasma volume and the concentration of plasma proteins increase; this increase in colloid osmotic pressure draws water from the aqueous humor into plasma. 9,16 In the present study there was a significant decrease in IOP during HD (from 16.71 ±2.51 at pre-HD to 15.52 ±3.18 at end-HD), which might have been due to the improvement in HD techniques since the time the earlier studies were performed. Slower HD may prevent abrupt changes in mOsm, and fluid shift to the eyes may be limited.…”

“…6 During HD, an increase in colloid osmotic pressure draws water from the aqueous humor into plasma. 9,16 In the present study, the effect of elevated colloid osmotic pressure on IOP might have been greater than the effect of the decrease in mOsm on IOP, which is why HD led to lower IOP values. Despite the reported marked rise in IOP, in the present study there was a 1.2 mm Hg of IOP decrease during HD, which is also comparable with the study conducted by Tokuyama.…”

“…7 Some studies reported that there is no correlation between mOsm and IOP, while others reported no change in IOP during HD. 10,11,13,16 Tokuyama et al observed a decrease in IOP (−1.8 mm Hg) and plasma osmolarity following HD, but not a significant correlation between IOP and plasma osmolarity; however, they did note a correlation between IOP and plasma colloid osmotic pressure (r = −0.510, p = 0.0012) and a change in body weight (r = 0.534, p = 0.0006). 9 According to Fauchald, plasma colloid osmotic pressure is critical to hydrodynamic changes during HD.…”

Effect of hemodialysis on intraocular lens power calculation

“…6 13 found that anterior chamber depth (ACD) significantly decreased during HD, whereas axial length (AL) remained unchanged. It can be summarized that a clearness regarding the effect of HD on ocular biometric parameters and intraocular power calculation, which is calculated by using biometric parameters has not yet been reached.…”

Intraocular pressure changes during hemodialysis

“…previously published studies appear inconsistent [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][23][24][25][26][27]. This may be attributed to the methodological differences, such as different exclusion criteria, variable sample size and different tonometry techniques and possibly due to significant technical progress in the HD procedure itself over the years [28].…”