Pars plana vitrectomy with silicone oil or gas endotamponade in HIV-related rhegmatogenous retinal detachments in Thai patients.

OBJECTIVE: To evaluate the efficacy and results of pars plana vitrectomy with endotamponade for retinal detachments caused by necrotizing retinitis in HIV patients. MATERIAL AND METHOD: The data of patients with HIV-related retinal detachment who underwent pars plana vitrectomy with silicone oil or gas endotamponade between January 2003 and June 2005 were retrospectively reviewed The outcome measures were demographic data, anatomical, and visual results. RESULTS: Of all 24 eyes from 20 patients, 19 eyes underwent pars plana vitrectomy with silicone oil tamponade and 5 eyes with long-acting gas tamponade. Mean follow up time was 13 months (range 2-33 months). The overall anatomical success was 83% (84% and 80% with silicone oil and gas tamponade, respectively). Final best corrected visual acuity was equal or better than 5/200 in 12 eyes (50%). Forty-six percent had stabled or improved vision at the end of follow-up. CONCLUSION: Pars plana vitrectomy with silicone oil or gas tamponade gives the high anatomical success rate in the repair of retinal detachments caused by necrotizing retinitis in HIV patients. There were the same reattachment rate and visual results between the two tamponade groups. However, the use of gas tamponade may be effective in patients with highly active antiretroviral therapy (HAART).

Outcomes of scleral buckling for stage 4 retinopathy of prematurity in Thai children.

OBJECTIVE: To evaluate the anatomical and visual results of a primary scleral buckling procedure for the treatment of stage 4A and 4B retinopathy of prematurity (ROP) in Thai patients. MATERIAL AND METHOD: The data of premature infants treated with a primary scleral buckling procedure for stage 4 ROP from December 2000 to May 2004 were retrospectively reviewed The outcomes measures were anatomical success, visual outcomes, and refractive error at the end of follow-up. RESULTS: Sixteen eyes of ten patients underwent a scleral buckling procedure and had the mean follow-up period of 17.3 months (range 3-44 months). The anatomical success was 100% (8 of 8 eyes) in stag 4A and 50% (4 of 8 eyes) in stage 4B. At the end of the follow-up, the buckle was removed in 92% (11 of 12 eyes) of retina-attached eyes and showed a mean myopic refraction of-8.68 diopters (range -4. 75 to 13.50). Favorable visual outcome was 50% (4 of 8 eyes) in stage 4A and 12.5% (1 of 8 eyes) in stage 4B. CONCLUSION: Scleral buckling appears to play a role in reducing the progression from stage 4 to stage 5 ROP The anatomical success rate was excellent but the visual results remain challenging for these cases.