USE OF THE GANCICLOVIR IMPLANT IN THE TREATMENT OF RECURRENT CYTOMEGALOVIRUS RETINITIS

Objective: To evaluate the efficacy of the ganciclovir implant in the treatment of recurrent cytomegalovirus (CMV) retinitis. Methods: Patie nts with acquired immunodeficiency syndrome and recurrent CMV retiniti s were evaluated for entry into the study. A ganciclovir implant was i nserted in 91 eyes of 70 patients between October 1992 and October 199 5. The efficacy of the implant and visual results were retrospectively reviewed. Results: Fifty-three (76%) of 70 eyes had inactive CMV reti nitis 1 month postoperatively (positive initial response). Twenty-one eyes of 19 patients had less than 1 month of follow-up. Nineteen (36%) of 53 eyes developed recurrent CMV retinitis. The median time to recu rrence for those patients with a positive initial response was 7 month s. Forty-eight (84%) of 57 patients with follow-up longer than 1 month after implant insertion in the first eye received systemic anti-CMV m edication during the study. The cumulative risk for developing a retin al detachment was 23% at 6 months following implant insertion. Other c omplications included vitreous hemorrhage, hyphema, and suprachoroidal implantation of the device. Conclusion: The ganciclovir implant is ef fective as an adjunct to continued systemic therapy in those patients with recurrent CMV retinitis.