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Replacement of the Ganciclovir Implant

The primary reason for CMV relapse in an eye treated initially with a ganciclovir implant is drug depletion from the device, which typically occurs by six to eight [Pg.340]

Some other uncommon complications include macular edema, vitreous hemorrhage, hypotony, cataract (Fig. 6), temporary reduced vision secondary to astigmatism, implant malposition, and retinal detachment, which is more likely if the CMV infection involves over 25% of the retina (100). Lim and colleagues evaluated a series of 110 ganciclovir implant procedures and noted posterior segment complications in 12% (111). Some of these eyes had undergone multiple prior implant procedures and [Pg.341]

There are some relative contraindications to use of the ganciclovir implant. The risk of using the implant in an individual with limited life expectancy should be carefully considered, although the immune status can be markedly improved with HAART. Other relative contraindications include implantation when there is an ocular surface infection or systemic coagulopathy. Extraocular ganciclovir resistant viral strains may be a relative contraindication, although more than one strain of CMY can infect an individual and the resistant isolate from the blood or extraocular tissue may not reflect the CMV strain in the eye (116). [Pg.342]

Hennis HL, Scott AA, Apple DJ. Cytomegalovirus retinitis. Surv Ophthalmol 1989 34 193. [Pg.343]

Baumal CR, Levin AV, Read S. Cytomegalovirus retinitis in immunosuppressed children. Am J Ophthalmol 1999 106 301-305. [Pg.343]


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