A study on perioperative related ocular parameters in elderly cataract patients undergoing maintenance hemodialysis
Objective To investigate the changes of ocular parameters(visual acuity,intraocular pressure,corneal pa-rameters,anterior chamber depth and ocular axis)during perioperative period in elderly cataract patients undergoing hemodialy-sis(HD).Methods Continuous patients who underwent phacoemulsification combined with IOL implantation in Department of Ophthalmology,Zhabei Central Hospital,Jing'an District from January 2019 to December 2020 were collected.Among them,patients diagnosed with renal failure and undergoing HD were included in the nephropathy group.The changes of intraoc-ular pressure,corneal parameters,anterior chamber depth and axial length 1 h before HD,1 h after HD and at HD interval of the nephropathy group were compared.At the same time,the above indexes were compared with those of the control group.Results During different periods of HD,patients'intraocular pressure fluctuated.There was no significant difference in preop-erative corneal thickness between the nephropathy group and the control group,but the corneal thickness of the nephropathy group was significantly greater than that of the control group on the first day after surgery,and this difference disappeared one month after surgery.The depth of anterior chamber of the nephropathy group 1 h after HD was significantly smaller than that 1 h before HD and at HD interval.One month after the cataract operation,the depth of the anterior chamber of the nephropathy group was significantly greater than that before surgery.The visual acuity recovery of the nephropathy group was worse than that of the control group on the first day and one month after surgery.One month after the operation,the mean absolute diopter errors measured at different periods of HD showed a statistically significant difference(F=6.572,P=0.002),and there was also a statistically significant difference compared to the control group(t=3.771,P=0.001).Conclusion The intraocular pressure and anterior chamber depth of HD patients would fluctuate in different periods of HD.Therefore,the predicted degree of lens can be more accurate if appropriate time is selected for preoperative examination of cataract patients with maintained HD.Compared with ordinary cataract patients,those patients treated with maintained HD may be more likely to have corneal edema and elevated intraocular pressure on the first day after cataract operation.The surgical prognosis in HD patients is worse than that in ordinary cataract patients.
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