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Biomedical subjects

James P Dunn

Publications and source records attributed to James P Dunn.

At least 19 recordsLinked to original sources
PubMed2006

Risk factors for ocular complications and poor visual acuity at presentation among patients with uveitis associated with juvenile idiopathic arthritis.

PURPOSE: To describe the frequencies of and risk factors for ocular complications and poor visual acuity at presentation in a cohort of patients with juvenile idiopathic arthritis (JIA)-associated uveitis. DESIGN: Cross-sectional study. METHODS: setting: Single-center, academic practice. study population: Seventy-five patients with JIA-associated uveitis were evaluated between July 1984 and August 2005. observation procedures: Data on patients diagnosed with JIA-associated uveitis were entered retrospectively into a database and analyzed. outcome measures: Visual acuity of 20/50 or worse or 20/200 or worse, and presence of ocular complications (including cataract, posterior synechiae, band keratopathy, elevated intraocular pressure, hypotony, macular edema, and epiretinal membrane) at presentation. RESULTS: At presentation, ocular complications were seen in 67% of eyes affected by JIA-associated uveitis. Presence of > or =1+ anterior chamber flare, a positive antinuclear antibody (ANA), and a shorter duration between the diagnosis of arthritis and uveitis were significantly associated with the presence of ocular complication. The frequencies of 20/50 or worse and of 20/200 or worse visual acuities at presentation in affected eyes were 36% and 24%, respectively. The presence of > or =1+ anterior chamber flare and a history of intraocular surgery before presentation were significantly associated with 20/50 or worse and 20/200 or worse vision. Presence of posterior synechiae also was associated with 20/200 or worse vision at presentation. The main causes of poor vision at presentation for affected eyes and better-seeing eyes were cataract, band keratopathy within the visual axis, and glaucoma. CONCLUSIONS: Ocular complications and poor vision at presentation were common in our patients with JIA-related uveitis.

Adolescent↗
PubMed2006

Multifocal choroiditis with panuveitis incidence of ocular complications and of loss of visual acuity.

PURPOSE: To estimate the incidences of ocular complications and vision loss in patients with multifocal choroiditis with panuveitis (MFCPU) and to describe the association between therapy and the incidences thereof. DESIGN: Retrospective cohort study. PARTICIPANTS: Sixty-six patients (122 eyes) with MFCPU evaluated from January 1984 through June 2005 at a single-center academic practice. METHODS: Demographic and clinical information on patients diagnosed with MFCPU was collected and entered into a computerized database for statistical analyses. MAIN OUTCOME MEASURES: Development of ocular complications, including choroidal neovascularization, epiretinal membrane, and cystoid macular edema (CME), and loss of visual acuity (VA) to 20/50 or worse and to 20/200 or worse. RESULTS: Among affected eyes of patients with MFCPU, frequencies of VAs of 20/50 or worse and of 20/200 or worse at presentation were 55% and 38%, respectively. Choroidal neovascularization was observed in 22% of affected eyes at presentation and was the leading cause of poor VA at presentation. The incidence rates of vision loss to 20/50 or worse and to 20/200 or worse were 0.19/eye-year (EY) and 0.12/EY in affected eyes and 0.07/person-year (PY) and 0.04/PY in better-seeing eyes. Choroidal neovascularization was the most common cause of incident vision loss, with approximately 45% of incident vision loss attributed to new-onset or recurrent choroidal neovascularization. Presence of epiretinal membrane and CME also was associated with the development of vision loss during follow-up. When taken in combination, the incidence of any posterior pole complication was 0.13/EY in affected eyes. Use of immunosuppressive drug therapy (but not low-dose corticosteroid therapy) was associated with an 83% reduction in the risk of posterior pole complications (P = 0.004) and with a 92% reduction in the risk of 20/200 or worse VA in affected eyes (P = 0.05). Of the 6 eyes with recurrent choroidal neovascularization, only one recurrence was observed, in a patient receiving immunosuppressive drug therapy. CONCLUSIONS: Treatment with immunosuppressive drugs may improve VA outcomes among patients with MFCPU by reducing the risk of sight-threatening posterior pole complications, including new-onset choroidal neovascularization and recurrent choroidal neovascularization among eyes with existing choroidal neovascularization.

Adolescent↗
PubMed2005

Incidence of cytomegalovirus (CMV) retinitis in second eyes of patients with the acquired immune deficiency syndrome and unilateral CMV retinitis.

PURPOSE: To evaluate the risk and risk factors for developing cytomegalovirus (CMV) retinitis in previously uninvolved second eyes among patients with unilateral CMV retinitis. DESIGN: Cohort study. METHODS SETTINGS: Single-center academic AIDS ophthalmology practice. PATIENT POPULATION: Three hundred seventy-six consecutive patients with AIDS and unilateral CMV retinitis were followed from the time of CMV retinitis diagnosis for the development of second-eye retinitis. EXPERIMENTAL PROCEDURES: Demographic and clinical characteristics were noted at baseline. Use of highly active antiretroviral therapy (HAART) and immune recovery in response to HAART were noted prospectively. MAIN OUTCOME MEASURE: Development of CMV retinitis in a previously uninvolved eye. RESULTS: Ninety-one percent of subjects received systemic anti-CMV treatment. Second-eye retinitis occurred in 26.1%/person-year (19.6% within the first 6 months), less than half the rate previously reported in untreated groups. Initial CD4+ T cell count >12 cells/microl, use of HAART, and initial posterior pole involvement were associated with 64%, 46%, and 41% reductions in incidence vis-à-vis comparison groups. Benefit from HAART was limited to that subset who developed immune recovery of a degree expected to restore innate control of CMV (a rise in the CD4+ T cell count by >50 cells/microl to a level >100 cells/microl). CONCLUSIONS: The risk of second-eye retinitis is substantial in patients with unilateral CMV retinitis but appears to be reduced by anti-CMV therapy and by HAART-induced immune recovery. Patients are at highest risk when CD4+ T cell counts are very low and in the months immediately after CMV retinitis diagnosis.

AIDS-Related Opportunistic Infections↗
PubMed2005

Birdshot retinochoroidopathy: ocular complications and visual impairment.

PURPOSE: To describe the incidence of vision loss and of ocular complications attributable to birdshot retinochoroidopathy and to describe the association between therapy and the incidence thereof. DESIGN: Retrospective cohort study. METHODS SETTING: Single-center, academic practice. STUDY POPULATION: Forty patients with birdshot retinochoroidopathy were evaluated from January 1984 through March 2004. OBSERVATION PROCEDURE: Demographic and clinical information on patients diagnosed with birdshot retinochoroidopathy was collected. MAIN OUTCOME MEASURES: Visual acuity and visual field loss; ocular complications including cystoid macular edema (CME). RESULTS: In affected eyes, the frequencies of vision loss to 20/50 or worse and to 20/200 or worse and of CME at presentation were 33%, 13%, and 20%, respectively. Patients who presented with a duration of disease of > or = 30 months had higher frequencies of visual impairment to 20/50 or worse (68% vs 32%; P = .004) and to 20/200 or worse (32% vs 9%; P = .01), and had a higher frequency of CME (38% vs 14%; P = .02) than patients who presented with a duration of disease <30 months. The incidence rates on follow-up for vision loss to 20/50 or worse and to 20/200 or worse were 13% and 4% per eye-year (EY), respectively. The incidence of CME was 10%/EY. Use of immunosuppressive drug therapy was associated with a reduced risk of developing CME (relative risk = 0.17; 95% confidence interval: 0.05, 0.64; P = .009). CONCLUSIONS: Birdshot retinochoroidopathy is a progressive disease with the potential for visual impairment. Patients who present at a later date after the onset of disease were more likely to have vision impairment and CME. Use of long-term immunosuppressive therapy may reduce the risk of CME.

Adolescent↗
PubMed2005

Vogt-Koyanagi-Harada disease: clinical outcomes.

PURPOSE: To evaluate the effect of treatment on the incidence of vision impairment and structural ocular complications among patients with Vogt-Koyanagi-Harada (VKH) disease. DESIGN: Retrospective cohort study. METHODS: setting: Single-center academic practice. study population: Twenty-four consecutive patients with VKH disease who were referred for evaluation and treatment from November 1984 through May 2004. procedures: Information on patients with VKH disease was entered retrospectively into a database and analyzed with time-dependent techniques. main outcome measures: Incidence of visual impairment and of structural ocular complications. RESULTS: In better-seeing eyes, the frequencies of vision loss to 20/50 or worse and to 20/200 or worse at presentation were 50% and 30%, respectively. The incidence rates on follow-up examination for vision loss to 20/50 or worse and to 20/200 or worse were 9% per person-year and 7% per person-year in the better-seeing eye. Oral corticosteroid therapy was associated with a reduced risk of loss of visual acuity to the 20/200 or worse in the better-seeing eye (relative risk [RR] = 0.33; P = .05). The use of immunosuppressive drug therapy was associated with a reduced risk of vision loss to the 20/50 or worse and to the 20/200 or worse thresholds in the better-seeing eye (RR = 0.33; P = .05; and RR = 0.08; P = .04, respectively). CONCLUSION: VKH disease may result in substantial visual impairment. The use of oral corticosteroid or immunosuppressive drug therapy may reduce the risk of vision loss during the follow-up period.

Adult↗
PubMed2005

Mycophenolate mofetil therapy for inflammatory eye disease.

PURPOSE: To evaluate treatment outcomes with mycophenolate mofetil in patients with inflammatory eye disease. DESIGN: Retrospective case series. PARTICIPANTS: Eighty-four consecutive patients with inflammatory eye disease treated with mycophenolate mofetil at an academic referral center. METHODS: Medical records were reviewed for treatment with mycophenolate mofetil. Dose of mycophenolate mofetil, response to therapy, dose of prednisone, use of other immunosuppressive drugs, and side effects associated with the use of mycophenolate mofetil were recorded. MAIN OUTCOME MEASURES: Ability to control ocular inflammation with mycophenolate mofetil and to taper prednisone to < or =10 mg daily, and incidence of treatment-related side effects. RESULTS: Of the 84 patients treated with mycophenolate mofetil, 61% had uveitis, 17% had scleritis, 11% had mucous membrane pemphigoid, and 11% had orbital or other inflammatory disease. Forty-three percent of patients treated with mycophenolate mofetil had been treated with at least one other immunosuppressive drug previously. The median dose of prednisone at the start of mycophenolate mofetil therapy was 40 mg, and 82% of the patients were considered a treatment success, as judged by the ability to control the inflammation and taper prednisone to < or =10 mg daily. Median time to treatment success was 3.5 months. Mycophenolate mofetil therapy was discontinued due to insufficient efficacy at a rate of 0.10 per person-year (PY) and due to side effects at a rate of 0.08/PY. The most frequent side effect was gastrointestinal upset, with a rate of 0.19/PY. CONCLUSIONS: These data suggest that mycophenolate mofetil may be an effective corticosteroid-sparing agent in the treatment of inflammatory eye disease with a manageable side effect profile.

Adolescent↗
PubMed2005

Retinal vascular occlusion in patients infected with human immunodeficiency virus.

PURPOSE: To describe the clinical features of retinal vascular occlusions (macrovasculopathy) and the proportion of affected patients with human immunodeficiency virus (HIV) infection. METHODS: Retrospective chart review of all HIV-infected individuals with retinal vascular occlusions seen at a single tertiary care clinic between November 1983 and May 1998. RESULTS: Retinal vascular occlusion was found in 38 eyes of 33 (1.3%) of the 2,484 consecutive patients examined. Of the 33 patients, 16 (48.5%) had central retinal vein occlusion, 9 (27.3%) had branch retinal vein occlusion, 4 (12.1%) had hemiretinal vein occlusion, and 1 each (3.0%) had central retinal arterial occlusion, branch retinal arterial occlusion, and combined hemiretinal vein occlusion and branch retinal artery occlusion. One patient (3.0%) had Purtscher-like retinopathy in one eye. Multiple regression analysis revealed that macrovasculopathy was associated with the presence of noninfectious retinal microvasculopathy (odds ratio, 5.76; 95% confidence interval, 2.59-12.80). Vision at the time of diagnosis ranged between 20/20 and no light perception. Twenty-five (75.8%) of the 33 patients had follow-up examinations for a mean period of 9.1 months. Ocular findings during follow-up included capillary dropout in 3 patients (11.5%), posterior pole neovascularization in 4 (15.4%), vitreous hemorrhage in 4 (15.4%), and optic atrophy in 6 (23.1%). Vision at the last eye examination ranged between 20/20 and no light perception and was 20/200 or worse in 15 (39.5%) of 38 eyes. CONCLUSIONS: Patients with HIV infection have a small risk of retinal vascular occlusion, but complications and visual loss are common in affected patients. There is a strong association between noninfectious retinal microvasculopathy and retinal vein occlusions.

Adult↗
PubMed2005

Preclinical evaluation of a novel episcleral cyclosporine implant for ocular graft-versus-host disease.

PURPOSE: To develop a local drug delivery system that provides therapeutic cyclosporine levels to treat lacrimal gland graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. METHODS: Episcleral cyclosporine implants were manufactured with a silicone-based matrix design, and in vitro release rates were determined. Preclinical evaluation included toxicology (clinical examination, serial electroretinography, and histopathology) in normal rabbits and dogs, pharmacokinetics in normal rabbits, and pharmacodynamics in a canine model of aqueous tear deficiency and keratoconjunctivitis sicca. RESULTS: The cyclosporine implants showed sustained release of drug over time with in vitro assays. Histopathology showed normal ocular tissues in both dogs and rabbits 6 months after implantation. The cyclosporine implant produced lacrimal gland drug levels 1 to 2 log units higher than those reported with a variety of topical cyclosporine formulations and oral administration. The cyclosporine implant was effective in a canine model of keratoconjunctivitis sicca, with all animals able to discontinue topical cyclosporine and maintain normal Schirmer scores over a 6-month follow-up. CONCLUSIONS: This preclinical evaluation showed that the episcleral cyclosporine implant was safe, delivered potentially therapeutic cyclosporine levels to the lacrimal gland, and showed efficacy in a clinically relevant model of keratoconjunctivitis sicca. The episcleral cyclosporine implant shows promise in reducing the morbidity associated with lacrimal gland graft-versus-host disease after allogeneic hematopoietic stem cell transplantation. In addition, continuous release of cyclosporine in the subconjunctival space with the episcleral implant was an effective means of delivering drug to the ocular surface and may have potential in treating other ocular inflammatory diseases.

Animals↗
PubMed2005

Ganciclovir implant in the treatment of cytomegalovirus retinitis.

The ganciclovir implant is a sustained-release intraocular drug delivery system used to treat cytomegalovirus retinitis that provides a high and steady-state concentration of the drug in the vitreous cavity over a period of 7-8 months. Randomized, controlled clinical trials have demonstrated a superior efficacy of the implant compared with intravenous ganciclovir. Severe adverse events associated with the implant are uncommon, though potentially blinding. In addition, the implant provides no protection against second-eye or visceral cytomegalovirus retinitis infections. This review summarizes the clinical indications for and complications associated with the ganciclovir implant.

AIDS-Related Opportunistic Infections↗
PubMed2004

Comparability of two fundus photograph reading centers in grading cytomegalovirus retinitis progression.

PURPOSE: To compare grading of cytomegalovirus retinitis progression by two different fundus photograph reading centers (FPRCs). DESIGN: Patients with AIDS followed in an ophthalmology service were enrolled in a prospective epidemiologic study of the prevalence and incidence of resistant cytomegalovirus in vitro. METHODS: We compared masked replicate gradings by two different FPRCs of monthly fundus photographs for retinitis progression (onset of a separate new lesion or expansion of an existing lesion by > or =one-half disk diameter). RESULTS: For 77 patients, Kaplan-Meier plots of progression over time were similar between FPRCs (median time to progression, 65 vs 69 days). Agreement between FPRCs was 51% (kappa [kappa] =.37, "fair") on exact visit of progression (28 patients) or on absence of progression through follow-up (11 patients) and 62% (kappa =.38) on progression visit +/- 1 month. Eight of 12 patients with progression graded as more than 1 month apart were only 2 months apart. Considering each monthly visit as a choice point, overall agreement on progression was 78% (kappa =.55, "moderate"). Baseline evaluation of retinitis showed 95% agreement on presence/absence and a concordance correlation coefficient of.75 for extent in combined zones 1 and 2. Rates of retinal loss over follow-up were estimated as 2.8%/month vs 2.0%/month (P =.015). CONCLUSIONS: By adopting similar protocols and procedures, different FPRCs can achieve good agreement on presence and extent of cytomegalovirus retinitis. Further efforts to harmonize evaluation through ongoing comparison of gradings would likely improve agreement on retinitis progression.

AIDS-Related Opportunistic Infections↗
PubMed2004

Clinical characteristics and outcomes of cytomegalovirus retinitis in persons without human immunodeficiency virus infection.

PURPOSE: To describe the characteristics and outcomes of patients with cytomegalovirus (CMV) retinitis in the absence of human immunodeficiency virus (HIV) infection. DESIGN: Retrospective cohort study. METHODS: Consecutive patients with CMV retinitis in the absence of HIV infection were identified at a university hospital. Demographic and clinical characteristics were noted at the time of CMV retinitis. Outcomes were determined retrospectively. Main outcome measures were rates of second eye involvement, vision loss, rhegmatogenous retinal detachment (RD), immune recovery uveitis, progression of retinitis, and mortality. RESULTS: The clinical characteristics of CMV retinitis in 18 patients (30 eyes) without HIV infection diagnosed between January 1, 1984, and April 13, 2003, were similar to those of patients with HIV infection. The incidences of visual loss to the levels of 20/50 or worse and of 20/200 or worse were 17% per eye-year and 14% per eye-year, respectively. The observed incidence of RD was 3.7% per eye-year, and the mortality rate was 23% per person-year. Following reduction of immunosuppression, 10 patients (56%) who discontinued anti-CMV therapy remained free of retinitis progression. The incidence of immune recovery uveitis was 13% per person-year. CONCLUSIONS: In our series, CMV retinitis in patients without HIV infection had a clinical course similar to that in patients with AIDS treated with highly active antiretroviral therapy (HAART), except the incidence of RD was lower for patients without AIDS. A substantial number of patients no longer required long-term anti-CMV therapy after adjustment of immunomodulatory therapy.

Adolescent↗
PubMed2004

Complications of ganciclovir implant surgery in patients with cytomegalovirus retinitis: the Ganciclovir Cidofovir Cytomegalovirus Retinitis Trial.

PURPOSE: To describe the complications of ganciclovir implant surgery in patients with cytomegalovirus retinitis. METHODS: Prospective data collection within the context of a randomized, controlled clinical trial, comparing a regimen of the ganciclovir implant plus oral ganciclovir to one of intravenous cidofovir for the treatment of cytomegalovirus retinitis in patients with AIDS. Adverse events were compared for patients undergoing implant surgery in the following groups: primary versus replacement implant surgery, inpatient versus outpatient surgery, and general versus local anesthesia. RESULTS: Fifty-six eyes of 42 patients underwent a total of 74 ganciclovir implant surgeries. Vitreous hemorrhage was the most common adverse event, occurring in 10% of eyes undergoing surgery with local anesthesia but in no eyes undergoing surgery with general anesthesia. All vitreous hemorrhages resolved within 60 days. Patients in the general anesthesia and inpatient surgery groups tended to have a lower risk of complications in the first 30 days than did patients in the local anesthesia and outpatient surgery groups, but no differences in the complication rate were found after 60 days. Visual acuity was similar among these different groups. There were no cases of endophthalmitis. CONCLUSION: Ganciclovir implant surgery in patients with AIDS and cytomegalovirus retinitis was associated with a low risk of serious complications in the first 60 days after surgery. Vitreous hemorrhage was the most commonly observed complication and resolved in all cases.

AIDS-Related Opportunistic Infections↗
PubMed2004

Review of immunosuppressive drug therapy in uveitis.

PURPOSE OF REVIEW: Uveitis is an important cause of functional visual loss and blindness in the developed world. Immunosuppressive drugs may be required to treat severe noninfectious uveitis successfully, but the efficacy and safety of such treatments are often limited by the small numbers of patients enrolled in clinical trials or studied retrospectively, the absence of control participants, and the variable natural course of some types of uveitis. This review was undertaken to highlight recent clinical advances in the treatment of severe noninfectious uveitis. RECENT FINDINGS: A literature search emphasizing the research published since 2001 was undertaken. The role of previously available immunosuppressives such as antimetabolites, calcineurin inhibitors, and alkylating agents continues to develop. In recent years, more specific drugs, collectively known as biologics, have been used in the treatment of uveitis. A persistent limitation of the published literature remains the general lack of randomized, controlled clinical trials. The long-term risks of most immunosuppressive drugs and the risk of relapse after discontinuation of therapy are also not well established. Tumor necrosis factor-alpha antagonists are promising but extremely expensive, and they may be more effective for rheumatologic and nonocular autoimmune disorders than for uveitis. SUMMARY: The number of options available for the treatment of severe noninfectious uveitis has expanded in the past few years. While promising, the new drugs are expensive, and their long-term efficacy and safety are not known; consequently, older immunosuppressive drugs still play an important role in the treatment of uveitis.

Alkylating Agents↗
PubMed2003

Mortality risk for patients with cytomegalovirus retinitis and acquired immune deficiency syndrome.

We prospectively followed up 589 patients to evaluate the relationship of anti-cytomegalovirus (CMV) treatment and immune reconstitution in response to highly active antiretroviral therapy (HAART) on the mortality risk of patients with CMV retinitis and acquired immune deficiency syndrome. The use of HAART was associated with an 81% lower mortality rate (95% confidence interval [CI], 74%-86%); it was 96% lower (95% CI, 92%-98%) for those who developed immune recovery and 49% lower (95% CI, 30-63%) for those who did not. Using time-updated multivariate analysis, current systemic anti-CMV treatment was independently associated with a 28% lower mortality rate (95% CI, 8%-43%). On the basis of these results, for patients who continue to have profound immunodeficiency despite HAART, the continued use of HAART and systemic anti-CMV therapy is predicted to reduce the risk of mortality by 65%, over and above the benefits of Pneumocystis carinii and Mycobacterium avium prophylaxis.

AIDS-Related Opportunistic Infections↗
PubMed2003

Risk of vision loss in patients with cytomegalovirus retinitis and the acquired immunodeficiency syndrome.

OBJECTIVE: To characterize the effect of cytomegalovirus (CMV) retinitis and its treatment on visual acuity in patients with the acquired immunodeficiency syndrome. METHODS: We evaluated 648 consecutive patients with the acquired immunodeficiency syndrome at 1 center for the prevalence of visual impairment at the time of CMV retinitis diagnosis and for the incidence of visual impairment across time. RESULTS: Among affected eyes, the prevalence of a visual acuity measurement of 20/50 or worse or 20/200 or worse at the time of CMV retinitis diagnosis was 33% and 17%, respectively. White race and injection drug use were associated with a lower and a higher prevalence of visual impairment, respectively. At 1 year, the cumulative incidence of loss of 3, 6, and 10 lines of visual acuity was 42%, 30%, and 23%, respectively, and the incidence of visual impairment to the level of 20/50 or worse and 20/200 or worse was 34% and 24%, respectively. Patients who received highly active antiretroviral therapy had an approximately 75% lower risk of visual impairment, with the greatest benefit among those observed to have immune recovery. The incidence of loss of visual acuity did not significantly differ between eyes treated with systemic anti-CMV therapy only, initial ganciclovir implant therapy, or systemic followed by implant therapy. CONCLUSIONS: The prevalence of visual impairment at the time of CMV retinitis diagnosis is high and varies according to demographic characteristics. The incidence of visual impairment during follow-up is also high but is substantially lower among patients who receive highly active antiretroviral therapy, especially those observed to have immune recovery.

AIDS-Related Opportunistic Infections↗
PubMed2003

Incidence and management of cataract after retinal detachment repair with silicone oil in immune compromised patients with cytomegalovirus retinitis.

PURPOSE: To determine the incidence of and risk factors for cataract and to describe the visual outcomes of cataract surgery in eyes with cytomegalovirus-related retinal detachments repaired with silicone oil. STUDY DESIGN: Retrospective cohort study. METHODS: A prospectively generated database of all patients with cytomegalovirus retinitis examined at a single tertiary care institution was used to identify all cases of retinal detachment between October 1983 and August 1997. Data on retinal detachment repair, development of cataract, and outcomes of cataract surgery were obtained retrospectively. RESULTS: Among 904 eyes of 587 immune-compromised patients diagnosed with cytomegalovirus retinitis, 198 eyes of 155 patients developed retinal detachment. Among these, 106 eyes of 90 patients underwent retinal detachment repair with silicone oil. The Kaplan-Meier estimated median time to cataract was 1.8 months after surgery with silicone oil. The adjusted relative risk of cataract in eyes that underwent retinal detachment repair with silicone oil compared with eyes that did not was 6.74 (P <.0001). Eight of the eyes that developed cataract underwent uncomplicated cataract surgery by phacoemulsification and posterior chamber intraocular lens implantation. Among these, six eyes experienced >or=2 lines of improvement in visual acuity. All developed posterior capsule opacification a median of 7 days after cataract surgery. Four of five eyes that that underwent neodymium:yttrium-aluminum-garnet laser capsulotomy experienced >or=2 lines improvement in visual acuity. CONCLUSIONS: There is a high incidence of cataract after surgery with silicone oil tamponade for cytomegalovirus-related retinal detachment. Posterior capsule opacification occurs rapidly after cataract surgery in these patients.

AIDS-Related Opportunistic Infections↗