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A.I. Fernando, O. Anderson, P. Puri, S.M. Mitchell; Visual Outcome of Cataract Extraction and Posterior Chamber Intraocular Lens Implantation in Patients With AIDS . Invest. Ophthalmol. Vis. Sci. 2005;46(13):767.
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Purpose: To evaluate the outcome of cataract surgery for patients with acquired immunodeficiency syndrome (AIDS) undergoing phacoemusification and posterior chamber IOL implantation. Methods: A prospectively generated database of all patients who underwent cataract extraction at a single tertiary care institution between April 1999 and March 2004 was generated. Data on patient demographics, visual acuity at cataract surgery, presence /absence of CMV retinitis (and if present macular involvement), the concurrent use of HAART and CMV treatment. Details of cataract surgery, perioperative complications and the final visual acuity were obtained retrospectively. Patients with any concurrent ocular pathology or previous vitreo retinal intervention were excluded from the study. Results: 20 eyes of 15 males aged 37 –68 years were included in the study. All patients were receiving HAART for HIV related disease, with 11 patients having had anti CMV treatment in the past, 2 patients still on oral ganciclovir and one patient receiving an intravitreal injection at time of surgery. The best corrected preoperative Snellen visual acuity was better than 6/12 in 5 eyes, between 6/12 and 6/24 in 4 eyes, between 6/36 and 6/60 in 5 eyes and worse than 6/60 in 6 eyes. All the patients underwent routine phacoemulsification with insertion of an acrylic posterior chamber implant. Post operative corneal oedema and a transient rise in the intraocular pressure was observed in 6 eyes with one eye developing postoperative retinal detachment. The final visual acuity was better than 6/9 in 10 eyes , between 6/12 and 6/24 in 4 eyes , between 6/36 and 6/60 in 5 eyes and worse than 6/60 in one eye. Involvement of the macular area with CMV retinitis was the major factor responsible for a poor visual outcome in 7 eyes. Conclusions: Phacoemulsification with intraocular lens implantation provided good visual recovery in patients with AIDS provided there is macular sparing CMV retinitis.
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