RETINAL-DETACHMENT IN AIDS - LONG-TERM RESULTS AFTER REPAIR WITH SILICONE OIL

Aims-To study the long term results of vitrectomy and silicone oil inj ection 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 t o viral retinitis was studied prospectively and followed until the las t patient in the series had died. Results-Median postoperative surviva l was 6 months, but 20% of patients survived 12 months or more. Wherea s best corrected visual acuity was 20/100 or better in over half the p atients 1-2 months after operation, there was a distressing decrease i n acuity by 6 months, owing to a variety of factors. Patients operated on before macular detachment did not have significantly better postop erative vision than those operated within a week after macular detachm ent. Almost all patients who had already lost vision in the fellow eye and many who had cytomegalovirus retinitis in the fellow eye with ret ention of good vision had their quality of life improved by the surger y 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-Althoug h the majority of patients recovered macular vision in the first 1-2 m onths after operation, there was a gradual decline in acuity thereafte r, sometimes without obvious cause. The results of this series suggest that it may be reasonable to postpone surgery until the macula detach es and that patients whose fellow eye is free of retinitis with normal vision are unlikely to have their quality of life improved significan tly by the surgery.