Wilmer Eye Institute, Baltimore, Maryland.
Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania; and.
Retina. 2024 Sep 1;44(9):1565-1571. doi: 10.1097/IAE.0000000000004145.
To evaluate the long-term anatomic and visual outcomes in eyes with sickle cell retinopathy-related retinal detachments (RDs).
Patients who underwent surgery for sickle cell retinopathy-related RDs at the Wilmer Eye Institute or Wills Eye Hospital between 2008 and 2020 and followed for at least 6 months postoperatively were retrospectively reviewed. The primary outcome was the rate of single-surgery anatomic success and final reattachment.
This study included 30 eyes from 28 patients (16 women and 12 men) with tractional RD (n = 13), rhegmatogenous RD (n = 1), and combined tractional RD/rhegmatogenous RD (n = 16). Mean age was 42.1 ± 15.1 years. The mean follow-up duration was 47.8 ± 34.1 months. Twenty-five (83.3%) eyes underwent pars plana vitrectomy and five (16.7%) eyes underwent pars plana vitrectomy with scleral buckling. Single-surgery anatomic success was achieved in 21 (70.0%) eyes at 6 months. 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 silicone oil tamponade (P = 0.024). Overall, the logarithm of the minimum angle of resolution visual acuity improved from 1.53 ± 0.57 (Snellen equivalent, 20/678) to 1.15 ± 1.01 (20/283) at the final visit (P = 0.03); however, eyes with recurrent RD did not achieve significant visual improvement.
Pars plana vitrectomy to repair sickle cell retinopathy-related RDs was effective in achieving anatomic success and improving vision in most eyes. Single-surgery anatomic success is critical for optimizing visual outcomes.
评估镰状细胞视网膜病变相关视网膜脱离（RD）患者长期的解剖和视力结果。
回顾性分析 2008 年至 2020 年期间威尔默眼科研究所或威尔斯眼科医院接受镰状细胞视网膜病变相关 RD 手术且术后至少随访 6 个月的患者。主要结局是单次手术解剖成功和最终复位的比率。
本研究纳入了 28 例（16 名女性和 12 名男性）30 只眼的病例，其中牵拉性 RD（n = 13）、孔源性 RD（n = 1）和牵拉性 RD/孔源性 RD 混合性 RD（n = 16）。平均年龄为 42.1 ± 15.1 岁。平均随访时间为 47.8 ± 34.1 个月。25 只（83.3%）眼行玻璃体切除术，5 只（16.7%）眼行玻璃体切除术联合巩膜扣带术。6 个月时，21 只（70.0%）眼单次手术解剖成功。28 只（93.3%）眼最终复位（22 只眼[73.3%]无眼内填充物）。RD 复发与男性（P = 0.041）、无既往激光治疗（P = 0.032）、医源性裂孔（P = 0.035）、视网膜切除术（P = 0.034）和硅油眼内填充（P = 0.024）显著相关。总体而言，最小分辨角视力对数从 1.53 ± 0.57（Snellen 等价物，20/678）提高到 1.15 ± 1.01（20/283）（P = 0.03），但 RD 复发的眼视力没有显著改善。
玻璃体内切除术治疗镰状细胞视网膜病变相关 RD 可有效实现解剖复位，并使大多数眼视力提高。单次手术解剖成功是优化视力结果的关键。
