Patient And Doctor Set Their Sights On A Tiny Miracle

Sydney Morning Herald

Tuesday January 10, 1995

By MELISSA SWEET Medical Writer

Mrs Lorraine Cibilic was ready to throw in the towel a week ago. Going blind in one eye due to an AIDS-related disease was more than she could bear after 13 years of battling HIV infection.

But she rediscovered some hope when offered the chance to become one of the first Australians to undergo delicate microsurgery which may save the sight remaining in her other eye.

A tiny pellet of the drug ganciclovir will be sewn into the inside of Mrs Cibilic's eye at St Vincent's Hospital on Thursday. The drug will be released slowly over the next six months to control the infection which is destroying her retina.

Doctors expect the new procedure to be an advance in the treatment of eye infections caused by cytomegalovirus (CMV), one of the most distressing AIDSrelated complications.

Dr Peter McCluskey, the eye surgeon who will perform the operation, said current treatments for CMV retinitis were time-consuming and inconvenient. Patients had to spend hours each day hooked up to a machine having the drug infused intravenously, or had regular injections in the eye. The pellet treatment was expected to be more effective, to make a dramatic difference to patients' quality of life and to reduce the risk of side effects.

The pellet, made by the United States-based company Chiron Vision, is not approved for marketing in Australia but can be obtained through the Federal Department of Health's special access scheme.

The hospital will pay the $5,000 cost of Mrs Cibilic's pellet.

Professor Ron Penny, director of the Centre for Immunology at St Vincent's Hospital, said CMV eye disease took a terrible toll on AIDS patients, and that the implant offered "excellent potential" for improving their quality of life.

Dr McCluskey said CMV retinitis was becoming an increasing problem as more AIDS patients survived longer. Of the 30 per cent who developed CMV eye infection, about half lost sight in at least one eye.

Mrs Cibilic, 49, of Campbelltown, hopes the operation will allow her to go home from St Vincent's, where she has spent most of the past six weeks hooked up to an IV machine delivering drugs for CMV infection.

Mrs Cibilic contracted HIV from a blood transfusion after being involved in a car accident which killed her young daughter. She has had CMV eye disease for three years and lost the sight in her right eye recently.

"Coming to terms with the losing of the eyesight has been the hardest mountain for me to climb so far," she said.

"All of a sudden, you become dependent on others ... I was ready to throw it all in."