Effect of hemodialysis on intraocular lens power calculation

Background To evaluate changes in ocular biometric parameters after hemodialysis (HD) in patients with end-stage renal disease (ESRD). Methods Forty eyes of 40 patients undergoing HD were included in this cross-sectional study. Keratometry (K) readings, white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber depth (ACD), pupil diameter, lens thickness (LT), axial length (AL), and intraocular lens (IOL) power calculation were measured with Lenstar LS 900 (Haag Streit AG, Koeniz, Switzerland) before and after hemodialysis. Intraocular pressure (IOP) was measured with a non-contact tonometer (Tonopachy NT-530P, Nidek Co., LTD, Tokyo, Japan). Main outcomes were changes in biometric parameters after HD. Reliability of the measurements (intraclass correlation coefficients (ICCs)) and the effect size (Cohen's d) were also calculated. Results Mean difference in AL before and after HD was -0.041 +/- 0.022mm with ICCs>0.90 (p<0.001 and Cohen's d = 0.06). Pupil diameter was also significantly different before (4.28 +/- 0.81 mm) and after (4.44 +/- 0.79 mm) HD with ICCs>0.90 (p = 0.041 and Cohen's d = 0.20). Hemodialysis had no significant effect on K readings, WTW distance, CCT, ACD, LT, or IOP. Conclusion Axial length and pupil diameter increase after HD with small effect size, while HD does not significantly affect IOL power calculations.