Clear lens extraction with intraocular lens implantation during retinal detachment repair in patients with Acquired Immune Deficiency Syndrome (AIDS) [correction of autoimmune deficiency syndrome] and cytomegalovirus retinitis.
OBJECTIVE
To assess the outcomes of clear lens extraction with intraocular lens (IOL) implantation during repair of retinal detachment by vitrectomy with silicone oil tamponade in patients with acquired immunodeficiency syndrome (AIDS) and cytomegalovirus (CMV) retinitis.


METHODS
Retrospective, noncomparative case series.


METHODS
Twelve eyes of 10 patients with AIDS, CMV retinitis, and retinal detachment.


METHODS
All patients underwent phacoemulsification with posterior chamber IOL placement at the time of vitrectomy with silicone oil tamponade for repair of retinal detachment. A targeted postoperative refractive error of -5.00 diopters (D) to -3.00 D was chosen in an attempt to counteract the hyperopic effect of silicone oil.


METHODS
The following factors were evaluated: postoperative visual acuity, refractive error, and intraoperative and postoperative complications.


RESULTS
Median follow-up was 7 months (range, 1-46 months). For patients without macular necrosis, median best-corrected preoperative visual acuity was 20/75 (range, 20/20-20/800), and median best postoperative visual acuity was 20/50 (range, 20/20-20/400). Median final visual acuity was 20/140 (range, 20/25 to count fingers at 1 foot). The median postoperative refractive error (spherical equivalent) was -1.00 D (range, -4.00 D to +7.88 D). Reoperation was required in 3 of 12 eyes for recurrent macular detachment (1 with silicone oil underfill; 2 with proliferative vitreoretinopathy). The macula was attached in all eyes at last follow-up. Reattachment of the peripheral retina was achieved in 10 of 12 eyes. There were no anterior segment complications.


CONCLUSIONS
Clear lens extraction with IOL placement during repair of retinal detachment with silicone oil tamponade does not seem to increase complications and may improve long-term visual rehabilitation, improve retinitis management by allowing better posterior segment visualization throughout the postoperative course, and decrease overall cost and morbidity associated with cataract extraction as a second procedure.
Engstrom
Robert E
RE
Ocular Inflammatory Disease Center, Jules Stein Eye Institute, University of California at Los Angeles School of Medicine, 100 Stein Plaza, Los Angeles, CA 90095-7000, USA.
Goldenberg
David T
DT
Parnell
Jeffrey R
JR
Barnhart
Lisa A
LA
Holland
Gary N
GN
D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000328:Adult; D017726:Cytomegalovirus Retinitis / Q000150:complications*; D006801:Humans; D019654:Lens Implantation, Intraocular; D007908:Lens, Crystalline / Q000601:surgery*; D008875:Middle Aged; D018918:Phacoemulsification; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012827:Silicone Oils / Q000627:therapeutic use; D014792:Visual Acuity; D014821:Vitrectomy
D012827:Silicone Oils