SMARTQCSurgical Outcomes of Retinal Detachment Associated with Proliferative Sickle Cell Retinopathy

Abstract

Purpose: To evaluate the long-term anatomic and visual outcomes in eyes with sickle cell retinopathy (SCR)-related retinal detachments (RDs). Methods: Patients who underwent surgery for SCR-related RDs at the Wilmer Eye Institute or Wills Eye Hospital between 2008 and 2020 and followed for at least 6 months post-operatively were retrospectively reviewed. The primary outcome was the rate of single surgery anatomic success (SSAS) and final reattachment. Results: This study included 30 eyes from 28 patients (16 female and 12 male) with tractional RD (TRD) (n=13), rhegmatogenous RD (RRD) (n=1), and combined TRD/RRD (n=16). Mean age was 42.1 ± 15.1 years. Mean follow-up duration was 47.8 ± 34.1 months. Twenty-five (83.3%) eyes underwent pars plana vitrectomy (PPV) and 5 (16.7%) eyes underwent PPV with scleral buckle (SB). SSAS was achieved in 21 (70.0%) eyes at 1 year. Final reattachment was achieved in 28 (93.3%) eyes (22 eyes [73.3%] without tamponade). Recurrence of RDs was significantly associated with male gender (P=0.041), absence of previous laser (P= 0.032), iatrogenic breaks (P=0.035), retinectomy (P=0.034), and SO tamponade (OR 7.857, P= 0.024). Overall, the logarithm of the minimum angle of resolution (logMAR) visual acuity improved from 1.53 ± 0.57 (Snellen equivalent, 20/678) to 1.15 ± 1.01 (20/283) at final visit (p = 0.03); however, eyes with recurrent RD did not achieve significant visual improvement. Conclusion: PPV to repair SCR-related RDs was effective in achieving anatomic success and improving vision in most eyes. SSAS is critical for optimizing visual outcomes.