Pathological findings in eyes with the ganciclovir implant

Abstract

Abstract: : Purpose:To examine the pathological findings of eyes treated with the ganciclovir implant. Methods:Pathology specimens from 1993 to 1999 at the National Eye Institute were reviewed. Thirty–two eyes from 19 patients were identified with ganciclovir implants. The submitted eyes were then sectioned through the implant site and stained with hematoxylin and eosin, periodic acid–Schiff (PAS), and other special stains when needed. Operative notes and post–operative notes were also reviewed. Results:Scars of surgical perforation were present in all eyes. 31 of the 32 eyes had fibrous ingrowth from the implant site into the vitreous. Vitreous hemorrhage was present in 18 of the 32 eyes. Poor wound apposistion was found in two of the 32 eyes, both which had undergone multiple procedures. Foreign body giant cell reactions were found in the majority of the eyes related to suture material. Thirty–one of the 36 implant sites were completely within the pars plana plane, while the other 5 were either on the border of the pars plana and pars plicata (4) or within the pars plicata (1). Hyalinization and/or atrophy changes to ciliary body in the area of implantation were observed in 18 eyes. Conclusions:The ganciclovir implant is well tolerated within the eye. Fibrous ingrowth is present in most eyes and seems to be a benign occurrence. Microscopic vitreous hemorrhage is present in many eyes especially those which had multiple procedures. Proper surgical technique is required to prevent poor wound closure or misplacement of the implant.

Keywords: pathology: human • vitreoretinal surgery