the 65k limit is on most, because as im get intro that problem, is need that all vertices are loaded to shaders (registers) and they get this limit. Therefore mesh must be divided intro small chunks, and there is it problematic with texturing and etc..... ( this is for CryEngine, UDK, Unity ) this go for realtime engines.... its perfectly solved in Battlefield 3 - Frostbite 2 most of the meshes are procedural generated - Texture, displacement, normal map.... Something can be done with teselation but there are another problems too.
So a best solution is a LOD system with dynamic loading of meshes, only the one what is need is loaded to mem and released afther use. this need that a large mesh is divided into smaler pieces.
But as i get preview of very special eingine that work on pointclouds that are displayed - rendered as "mesh" not points. Autodesk buy the technolofy in november 2011 so it take time that is accesible to general public. but it could handle up to 2Bil points in realtime on standard hardware......