Surgical repair of cytomegalovirus-related retinal detachment without silicone oil in patients with AIDS.
OBJECTIVE
To analyze visual and anatomic results following surgical repair of cytomegalovirus (CMV)-related retinal detachment (RD) without silicone oil permanent tamponade.


METHODS
We analyzed five consecutive patients (six eyes) with acquired immunodeficiency syndrome and CMV-related RD that were repaired with pars plana vitrectomy with peeling of the posterior hyaloid, laser photocoagulation, encircling scleral buckle, and intraocular gas tamponade.


RESULTS
Preoperative vision ranged from 20/40 to hand motion. Total retinal reattachment was achieved in five of six eyes (83%). Macular reattachment was achieved in all eyes. Mean postoperative visual acuity was 20/40 (range 20/30-20/60). Mean postoperative follow-up was 12 months (range 7-19 months). All patients in this series presented with low preoperative CD4+ T-lymphocyte counts (mean, 24 cells per microL) and received highly active antiretroviral therapy. One retina (Patient 1) redetached 7 months after initial repair and was successfully reattached without using silicone oil. Postoperatively, visual acuity remains 20/30, and total retinal reattachment has been maintained for 16 months.


CONCLUSIONS
Good anatomic and visual success can be achieved and maintained in CMV-related RD without the use of silicone oil.
Canzano
J C
JC
Department of Ophthalmology, University of California, Davis, USA.
Morse
L S
LS
Wendel
R T
RT
D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D000077404:Cidofovir; D017726:Cytomegalovirus Retinitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D003596:Cytosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage; D005500:Follow-Up Studies; D015497:HIV-1 / Q000472:pathogenicity; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D063065:Organophosphonates; D009943:Organophosphorus Compounds / Q000627:therapeutic use; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery* / Q000821:virology; D012591:Scleral Buckling; D012827:Silicone Oils / Q000008:administration & dosage; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
D019380:Anti-HIV Agents; D005466:Fluorocarbons; D063065:Organophosphonates; D009943:Organophosphorus Compounds; D012827:Silicone Oils; D003596:Cytosine; C042852:perflutren; D000077404:Cidofovir; D013459:Sulfur Hexafluoride