EARLY PARS-PLANA VITRECTOMY WITHOUT BUCKLING PROCEDURE IN CYTOMEGALOVIRUS RETINITIS-INDUCED RETINAL-DETACHMENT

Background: Retinal detachments induced by cytomegalovirus (CMV) retin itis can often be treated successfully with a buckling procedure combi ned with vitrectomy and silicone oil instillation, but this technique yields varying visual results. Methods: To minimize operational trauma , pars plana vitrectomy and silicone oil instillation without addition al buckling was performed in a series of 11 consecutive patients with acquired immune deficiency syndrome (AIDS) and CMV-retinitis-induced r etinal detachment. Surgery was performed early in the course of the re tinal detachment: 6 patients (55%) had an attached macula, and 7 patie nts (64%) had a visual acuity of 20/200 or better. Results: After a me an follow-up period of 5 months (range, 1-9 months) 9 patients (82%) h ad a completely reattached retina and 9 patients (82%) had visual acui ty of 20/200 or better. The macula was reattached in all patients. A l ocalized detachment of the inferior retina was noted in 2 patients (18 %), and a second operation was required in one eye. Significant catara ct formation occurred in two patients during the follow-up period. Pro liferative vitreoretinopathy and increased intraocular pressure were n ot observed. Conclusion: Early vitrectomy without additional buckling procedures is justified in patients with CMV-associated retinal detach ment because it stabilizes the retinal situation without major complic ations and improves visual function.