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M9550832.TXT
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1995-03-25
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Document 0832
DOCN M9550832
TI Results of rhegmatogenous retinal detachment repair in cytomegalovirus
retinitis with and without scleral buckling.
DT 9505
AU Garcia RF; Flores-Aguilar M; Quiceno JI; Capparelli EV; Munguia D;
Kuppermann BD; Arevalo F; Freeman WR; Department of Ophthalmology,
University of California, San Diego; 92093-0946.
SO Ophthalmology. 1995 Feb;102(2):236-45. Unique Identifier : AIDSLINE
MED/95166520
AB PURPOSE: To determine if scleral buckling is of any benefit in surgical
repair of cytomegalovirus (CMV)-associated retinal detachment if
combined with vitrectomy, silicone oil, and inferior midperipheral
endolaser. MATERIALS AND METHODS: Twenty-two consecutive eyes with
CMV-associated retinal detachments were repaired with vitrectomy and
endolaser to all breaks and to the inferior midperipheral retina using
silicone oil without scleral buckling (group 1, control group) between
July 1987 and May 1992. Results were compared with another series of 56
consecutive eyes undergoing vitrectomy, silicone oil injection,
endolaser to all breaks, and 360 degrees encircling scleral buckling
(group 2, study group) between June 1992 and July 1993. RESULTS: Total
retinal reattachment rates were 84% for group 1 and 86% for group 2.
Rates of macular reattachment were 91% for group 1 and 91% for group 2.
Mean best postoperative refracted visual acuity was 20/66 for group 1
and 20/67 for group 2. Median best postoperative refracted visual acuity
was 20/74 for group 1 and 20/80 for group 2. These differences in
results between the two groups were not statistically significant. Mean
postoperative refractive error was +3.95 for group 1 and +4.92 for group
2. Patients who underwent surgery with the macula attached had a better
postoperative visual outcome. CONCLUSION: Scleral buckling may not be
necessary in CMV-related retinal detachment if repaired with vitrectomy,
silicone oil, and inferior midperipheral endolaser. Elimination of
scleral buckling may reduce intraoperative time, patient morbidity, and
the risk of an accidental needle stick. Patients with macula-on retinal
detachments also should be considered for surgery before macular
detachment.
DE Adult AIDS-Related Opportunistic Infections/*COMPLICATIONS Comparative
Study Cytomegalovirus Retinitis/*COMPLICATIONS Eye Infections,
Viral/*COMPLICATIONS Fundus Oculi Human Laser Surgery Middle Age
Retinal Detachment/ETIOLOGY/PATHOLOGY/*SURGERY *Scleral Buckling
Silicone Oils/ADMINISTRATION & DOSAGE Support, Non-U.S. Gov't Support,
U.S. Gov't, P.H.S. Treatment Outcome Visual Acuity Vitrectomy
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).