J Korean Ophthalmol Soc.  2002 Jul;43(7):1222-1229.

A Study of Intraocular Pressure During Hemodialysis in CRF Patients

• Seo SG
• Kim YI
• Kim YW
• Yun IH

Abstract

PURPOSE: Hemodialysis, a treatment for patients with severely compromised renal failure, is the elimination of osmotic active substances by diffusion. Some authors have reported that change in osmorality between the serum and the aquous humor during hemodialysis increased in intraocular pressure (IOP). We investigated the change of IOP and serum osmolarity during hemodialysis and the effect of oral carbonic anhydrase inhibitor (Diamox(R)), topical carbonic anhydrase inhibitor (Trusopt(R)) and oral hypertonic solution(glycerol).
METHODS
In 45 CRF patients (90 eyes) without glaucoma, IOP, serum osmorality, pH, and HCO3- were measured during hemodialysis, and oral carbonic anhydrase inhibitor (Diamox(R)), topical carbonic anhydrase inhibitor (Trusopt(R)) and oral hypertonic solution (glycerol) werw administered if IOP rose by over 6mmHg during hemodialysis. After adminitration of the agents, we checked effect of preventing IOP elevation and metabolic change during hemodialysis.
RESULTS
The intraocular pressure rose above 6 mmhg in 24 eyes (24.6%) during hemodialysis. Oral carbonic anhydrase inhibitor induced more severe metabolic acidosis than topical carbonic anhydrase inhibitor but topical carbonic anhydrase inhibitor was less effective in lowering IOP.
CONCLUSIONS
Because of more effective lowering of IOP and rare complications of metabolic acidosis, hypertonic solution (glycerol) was effective and safe in neovascular glaucoma and in glaucoma patients with severely damaged optic nerve.

Keyword

Carbonic anhydrase inhibitor (CAI); CRF; Glaucoma; Hemodialysis; Intraocular pressure(IOP)

MeSH Terms

Acidosis
Carbonic Anhydrases
Diffusion
Glaucoma
Glaucoma, Neovascular
Humans
Hydrogen-Ion Concentration
Intraocular Pressure*
Optic Nerve
Osmolar Concentration
Renal Dialysis*
Renal Insufficiency
Carbonic Anhydrases