Retinal detachment in AIDS: long term results after repair with silicone oil

Abstract

Aims-To study the long term results of vitrectomy and silicone oil injection in AIDS patients with retinal detachment due to viral retinitis. Methods-A consecutive series of 83 eyes in 75 AIDS patients who were treated with vitrectomy and silicone oil for retinal detachment due to viral retinitis was studied prospectively and followed until the last patient in the series had died. Results-Median postoperative survival was 6 months, but 20% of patients survived 12 months or more. Whereas best corrected visual acuity was 20/100 or better in over half the patients 1-2 months after operation, there was a distressing decrease in acuity by 6 months, owing to a variety of factors. Patients operated on before macular detachment did not have significantly better postoperative vision than those operated within a week after macular detachment. Almost all patients who had already lost vision in the fellow eye and many who had cytomegalovirus retinitis in the fellow eye with retention of good vision had their quality of life improved by the surgery in that the operated eye eventually became the better seeing eye. In no patient whose fellow eye was normal and free of retinitis, however, did the operated eye ever become the better eye. Conclusions-Although the majority of patients recovered macular vision in the first 1-2 months after operation, there was a gradual decline in acuity thereafter, sometimes without obvious cause. The results of this series suggest that it may be reasonable to postpone surgery until the macula detaches and that patients whose fellow eye is free of retinitis with normal vision are unlikely to have their quality of life improved significantly by the surgery.

Towards an ideal biomaterial for vitreous replacement: Historical overview and future trends

“…In addition, silicone oil is usually employed in the first surgical procedure in patients unable to position for gases, with need to air travel immediately after surgery [82] or suffering from AIDS and related retinal complications [83,84].…”

Outcomes of Complex Retinal Detachment Repair Using 1000- vs 5000-Centistoke Silicone Oil

“…Arch Ophthalmol. 2005;123:473-478 S ILICONE OIL WAS FIRST REported for the treatment of retinal detachment in 1962 1 and has been used increasingly as a retinal tamponade in the management of complex retinal detachments associated with cytomegalovirus necrotizing retinitis, [2][3][4][5][6][7][8][9][10][11] proliferative diabetic retinopathy, [12][13][14][15][16][17][18] giant retinal tears, [19][20][21][22][23][24][25][26][27][28] proliferative vitreoretinopathy, [29][30][31][32][33][34][35][36][37] and ocular trauma. [38][39][40][41][42][43][44][45] The National Eye Institute Silicone Study demonstrated the superiority of 1000-centistoke silicone oil compared with sulfur hexafluoride, and its comparability with perfluoropropane, for ...…”

Vitreoretinal Surgery

“…16.32 Despite reattachment of the retina in this patient with ARN, there is CMO of the macula Fig. This is characterised by posterior segment in fl ammation which causes secondary complications such as cystoid macular oedema (Irvine et al 1997 ) , vitreomacular traction (Canzano et al 1998 ) , vitreous haemorrhage from retinal neovascularisation (Wright et al 2003 ) , and even activation of previously quiescent infections of the retina such as mycobacteria (Zamir et al 2002 ) . This is characterised by posterior segment in fl ammation which causes secondary complications such as cystoid macular oedema (Irvine et al 1997 ) , vitreomacular traction (Canzano et al 1998 ) , vitreous haemorrhage from retinal neovascularisation (Wright et al 2003 ) , and even activation of previously quiescent infections of the retina such as mycobacteria (Zamir et al 2002 ) .…”

“…This has led to a massive reduction in the numbers of new cases of retinitis which may only occur when there is failure of or resistance to HAART (Uphold et al 1998 ;Mitchell et al 1999 ;Mocroft et al 2000 ;Jalali et al 2000 ) . Prior to HAART, this was linked to early mortality at approximately 6 months (Dugel et al 1991 ;Irvine et al 1997 ) . Prior to HAART, this was linked to early mortality at approximately 6 months (Dugel et al 1991 ;Irvine et al 1997 ) .…”