Researchers from China believe that clinicians should carefully examine pre-existing ocular comorbidities from chronic renal failure in, especially the fundus abnormalities that could significantly compromise the vision, before patients undergo phacoemulsification with intraocular lens (IOL) implantation. Their analysis of preoperative examination data and postoperative best-corrected visual acuity (BCVA) in patients with chronic renal failure showed that patients with renal anemia had lower visual acuity than other patients.

The study conducted one week, one month and three month follow-up examinations on patients who underwent phacoemulsification with IOL implantation. Comparing 42 patients (51 eyes) with chronic renal failure (failure and uremia) on hemodialysis or peritoneal dialysis with 40 patients (50 eyes) without the condition, the red blood cell count, hemoglobin, creatinine, urea, systolic blood pressure, diastolic blood pressure and pre- and post-op BCVA values were all significantly different. In the control group, the preoperative red blood cell count, hemoglobin, creatinine and urea values were not associated with the pre- or postoperative BCVA.

The researchers’ analysis indicates that the continuous poor renal function and anemia in chronic renal failure patients lead to ocular fundus lesions or ischemia and hypoxia of the optic nerve and retinal cells, which then affects the postoperative BCVA. They conclude that these patients could achieve relatively good visual outcomes after cataract surgery when the clinician effectively manages the underlying diseases.

Yin S, Zhang J, Hua X, et al. Analysis of factors associated with vision after cataract surgery in chronic renal failure patients on dialysis. BMC Ophthalmol. 2020; 20:211.