Elevated Intraocular Pressure Post-Hemodialysis after Simple Pars Plana Vitrectomy: A Case Report

Purpose: To report a case of marked elevated IOP during and post-dialysis after vitrectomy. Case: a 72 year-old man complained of transient blurred vision of left eye during hemodialysis after vitrectomy. Results: A 72 year-old male presented with marked IOP elevation of his left eye after hemodialysis. This episode did not happen before vitrectomy. Transient blurred vision was complained without headache or nausea when IOP was markedly elevated. Despite medication with timolol and xalatan, the marked IOP elevation of left eye after hemodialysis was still noted. Anterior chamber angle narrowing was found during OPD follow up postoperatively. After consulting with nephroloists, dialyhsate flow rate was shifted from 750ml/min to 500 ml/min and the acetate dialysate was replaced by a bicarbonate type. The marked IOP elevation decreased (55mmHg →35mmHg → 21mmHg). Transient blurred vision of left eye during dialysis rarely happened after dialysate parameters were changed. Conclusion: IOP elevation during or after dialysis is a rate complication in patients with ESRD in the recent years. This has been attributed to dialysate parameters and flow rate. However, if the angle is compromised, especially post-vitrectomy, transient markedly elevated IOP could occur when rapid dialysis is performed.