Technique and Outcomes of Vitreoretinal Surgery for Complications of Proliferative Sickle Cell Retinopathy

Abstract

Objective: To report the technique as well as the anatomic and visual outcomes of vitrectomy for vitreoretinal complications of proliferative sickle cell retinopathy (PSR). Methods: This was a retrospective review of case files of patients who had vitrectomy for complications of PSR at Goldberg’s stage 4 and 5 between January 2017 and June 2022 at Eye Foundation Hospital, Ikeja Lagos, Nigeria. Results: Within the period of the study, a total of 22 eyes (6 right eyes and 16 left eyes) of 21 patients diagnosed with either persistent vitreous hemorrhage (Goldberg PSR stage 4) or retinal detachment (RD) (Goldberg PSR stage 5) met the inclusion criteria. All eyes had three port pars plana vitrectomy. Eleven eyes (50%) had only vitrectomy, six eyes (27.3%) underwent combined vitrectomy with scleral buckling and vitrectomy combined with phacoemulsification was done in five eyes (22.7%). There was a statistically significant (P = 0.026) improvement in the postoperative best corrected mean logMAR visual acuity (0.88 ± 0.79) at the last follow-up visit compared to the presenting visual acuity (1.4 ± 1.0). All eyes (100%) achieved surgical success defined as clearing of vitreous hemorrhage and retinal reattachment at 1-week, 6, and 12 weeks postoperative review. Conclusion: Good anatomic success and improvement in visual acuity are achievable with surgery for advanced PSR at Goldberg stages 4 and 5.