Pathological findings in eyes with the ganciclovir implant.
OBJECTIVE
To examine the pathologic findings of eyes treated with ganciclovir implants.


METHODS
Retrospective consecutive case series.


METHODS
Thirty-three eyes from 19 AIDS patients with ganciclovir implants.


METHODS
Pathologic specimens collected from 1993 through 1999 at the National Eye Institute were reviewed. Thirty-three eyes from 19 patients were identified with ganciclovir implants. The submitted eyes then were sectioned through the implant site and stained with hematoxylin and eosin, periodic acid-Schiff, and other special stains when needed. Medical records, including operative and postoperative notes, were reviewed carefully.


METHODS
Light microscopic findings at and around the site of implantation.


RESULTS
Scars of surgical perforation were present in all eyes. Fibrous ingrowth developed from the implant site into the vitreous in 32 of the 33 eyes. Vitreous hemorrhage was present in 18 of the 33 eyes. Poor wound apposition was found in 2 of the 33 eyes, both of which had undergone multiple procedures. Foreign body giant cell reactions were observed in most of the eyes related to suture material. Thirty-two of the 37 implant sites were located within the pars plana, whereas the other 5 were either on the border of the pars plana and pars plicata (n = 4) or within the pars plicata (n = 1). Hyalinization, atrophic changes of the ciliary body in the area of implantation, or both were observed in 18 eyes.


CONCLUSIONS
The ganciclovir implant is well tolerated within the eye. Fibrous ingrowth is present in most eyes and seems to be a benign occurrence because of its limited extension. Microscopic vitreous hemorrhage is present in many eyes, especially those that underwent multiple procedures. Poor wound apposition occurred rarely and was found only in eyes that had undergone multiple procedures.
Srivastava
Sunil K
SK
Laboratory of Immunology, National Eye Institute, National Institutes of Health, Bethesda, Maryland 20892-1857, USA.
Martin
Daniel F
DF
Mellow
Susan D
SD
Parks
David J
DJ
Dastgheib
Kourosh
K
Chan
Chi-Chao
CC
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D001284:Atrophy; D002924:Ciliary Body / Q000473:pathology; D017726:Cytomegalovirus Retinitis / Q000188:drug therapy; D004343:Drug Implants; D005128:Eye Diseases / Q000473:pathology*; D005129:Eye Foreign Bodies / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D005549:Foreign-Body Reaction / Q000473:pathology*; D015774:Ganciclovir / Q000627:therapeutic use*; D015743:Giant Cells, Foreign-Body / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014822:Vitreous Body / Q000473:pathology*; D014823:Vitreous Hemorrhage / Q000473:pathology*; D014945:Wound Healing
D000998:Antiviral Agents; D004343:Drug Implants; D015774:Ganciclovir