Increases in intraocular pressure during hemodialysis in eyes during earlypostvitrectomy period

BACKGROUND AND OBJECTIVES: To identify risk factors for intraocular pressur e (IOP) increases during hemodialysis (HD) in the early postoperative perio d following pars plana vitrectomy (PPV). PATIENTS AND METHODS: Comparisons of 36 vitrectomized eyes of 22 diabetics undergoing maintenance HD with those of 138 eyes of 69 nonoperated patients . Serial IOPs were measured before PPV, after PPV/before dialysis, and duri ng dialysis. Serum osmolarity and blood pressure were also recorded. RESULTS: In 20 of 36 operated eyes (55.6%) and 18 of 138 nonoperated eyes ( 13.0%) IOP was increased (greater than or equal to 4 mm Hg) during HD. In t he operated group, marked increases (greater than or equal to 7 mm Hg) were noted in 9 eyes and ocular pain in 5 eyes. Eyes with pre-existing outflow obstruction and/or acute postoperative outflow compromise carried high risk s. No correlation with changes in serum osmolarity or blood pressure was fo und. CONCLUSION: Monitoring of IOP during HD seems warranted when diabetics with pre-existing out-flow obstruction and/or postoperative outflow compromise, undergo HD following PPV.