Phacoemulsification With Advanced Monofocal Iol Implantation In Chronic Kidney Disease(Ckd) Patients Undergoing Dialysis -A Retrospective Study

a retrospective study was done to evaluate quality of vision and safety after phacoemulsification and advanced monofocal IOL implantation in patients with CKD were undergoing dialysis 3 times per week.

medical records of CKD patients who were undergoing dialysis due to various pathology and underwent phacoemulsification with Eyhance IOL were evaluated. These patients are at a higher risk for post-operative inflammatory reactions due to their systemic disease. Inflammation risk are increased due to, systemic inflammatory state, oxidative stress, altered immune response. Quality of vision and safety of surgery were assessed over a period of mean 1 year.

52 eyes of 26 patients were studied. Period: June 2022 to December,2025. M:=18 ,F:=8 , Mean age ; M=55.3(48-64) and F=52.6(50-58) years. Inclusion:NS 3 to NS 4 sanile cataract with stage 3(n=10) ,stage 4(n=11) and stage 5(n=5) CKD. Exclusion: severe macular edema, follow up less than 3 months. Best corrected visual acuity (BCVA), IOP, slit lamp and fundus examination, SSOCT assessment of macular thickness and contrast sensitivity test were done.

52 eyes(26 patients) were studied and followed for 1 year(6 -36 mo).Initial BCVA was 6/12 - 6/60 and post-operative BCVA was 6/9 - 6/18. AC flare- 71%, Anterior uveitis - 22%, corneal edema - 26.6%,TASS - 3.9%, CME- 31.2%. Post-operative endophthalmitis- nil. Pre-op mean central macular thickness: 201.3 ± 24.8µm, post op mean CMT at 1 MO: 224.1 ± 53.8µm and at mean 12 mo follow up: 203.5± 25.1µm. There was mild increase in CMT at 6 mo, followed by a slight reduction towards baseline at 12 mo. The difference in CMT at presentation, at 6 mo and at 12 mo was not statistically significant.(p˃0.05)

Phacoemulsification with implantation of an advanced monofocal IOL was safe and effective in patients with CKD undergoing dialysis. In this retrospective study of 26 pts(52 eyes)the procedure showed favourable visual outcomes with low incidence and reversible with treatment complications. No cases of post-operative endophthalmitis were observed. Careful peri-operative management and close co-ordination with nephrology team are important to minimize systemic and ocular risks in these immune compromised patients. Phacoemulsification with advanced monofocal IOL implantation can provide successful visual rehabilitation(52/52 eyes,100%).