[Recurrent corneal swelling accompanying intermittent hemodialysis in terminal kidney failure (author's transl(].

Typical eye changes in dialysis patients, which have been attributed to an osmotic disequilibrium, are elevated IOP, retinal edema or detachment, and cataract. This paper reports on a 66-year-old aphakic patient on intermittent hemodialysis, who developed corneal changes that may also be consequential to a disequilibrium. During hemodialysis treatments she repeatedly developed corneal swellings and bullous detachment of the corneal epithelium. These changes were always reversible during the period between treatments. Examination with the reflecting microscope demonstrated an endothelial cell density of 600/mm2, which is assumed to be the threshold density capable of maintaining corneal integrity under normal conditions, but is inadequate under the osmotic stress induced by hemodialysis. Methods of treatment are discussed.