Purpose: To determine the effects of hemodialysis on intraocular pressure (IOP) and to evaluate the correlation of IOP changes with anterior chamber angle anatomy. Patients and Methods: The study included 80 eyes of 40 patients with chronic renal failure (CRF) undergoing hemodialysis at the High Technology Medical Center between October 2018 and October 2021. Hemodialysis (HD) was performed 3 times a week and the duration of the procedure was 3 - 5 hours. The enrolled patients were grouped according to the width of the anterior chamber angle. IOP was evaluated at three different times during HD. Intraocular pressure was measured in both eyes in an upright sitting position with iCare tonometer. Results: According to the study results, there was no statistically significant difference in the axial length between the three measurements (p = 0.232). In patients with normal anterior chamber depth, IOP decreased significantly (68.75%) or did not show any changes in their IOP during or after the session. In patients with moderate narrow-angle (22.5%), IOP revealed no statistically significant differences. In patients with narrow-angle (8.75%), there was a marked increase in IOP. Changes in intraocular pressure were correlated with the anatomy of the anterior chamber angle. Loss in body weight as a result of hemodialysis was statistically important (p < 0.01). Conclusion: A significant increase in mean was revealed during and after hemodialysis in patients with extremely narrow-angle in comparison to eyes with wide or moderately anterior chamber angle. Eyes with shallow anterior chambers are at risk of having impaired aqueous humor outflow facilities and, as a result, significantly increase IOP during HD. Because of the high prevalence of narrow angles in the Caucasian population, it is of clinical importance to investigate the IOP changes in patients on HD. The results of our study support the idea that iridocorneal angle anatomy is affecting IOP fluctuation occurring in patients with ESRD undergoing HD.
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