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. 1997 Mar;81(3):180–183. doi: 10.1136/bjo.81.3.180

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

A Irvine 1, L Lonn 1, D Schwartz 1, M Zarbin 1, F Ballesteros 1, S Kroll 1
PMCID: PMC1722134  PMID: 9135379

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.



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Figure 1  .

Figure 1  

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Empirical survival function of the proportion of patients surviving from the date of treatment. The time from the treatment of the first eye was used for the eight cases with bilateral treatment. All cases were followed until the time of death. Percentage survival times—0.0-0.5 year 47%; 0.5-1.0 year 32%; more than 1.0 year 21%.

Figure 2  .

Figure 2  

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Non-parametric smoothed estimates for the proportion of eyes retaining visual acuity of at least 20/50, 20/100, 20/200, and 20/400. The proportion of time 0 is equal to the cohort proportion at the time of treatment. The post-treatment improvement in visual acuity decreased to the pretreatment level at about 6 months.

Figure 3  .

Figure 3  

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Kaplan-Meier estimate of the proportion of patients developing 3+ nuclear cataracts. Patients without known cataract development were censored at their last ophthalmic visit. The first follow up visit with 3+ cataract was used for the time of onset. The 95% confidence intervals (broken lines) are also displayed. The estimated median time to 3+ cataract was 7.3 months.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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