title: Vitreoretinal management and surgical outcomes in proliferative sickle retinopathy: a case series.
abstract: OBJECTIVE
  To report the outcomes of current vitreoretinal surgical management of proliferative sickle retinopathy and to compare current methods to previous studies.
  
  
  METHODS
  A retrospective, interventional case series.
  
  
  METHODS
  Fifteen eyes of 14 patients with proliferative sickle retinopathy were managed with vitreoretinal surgery over a 12-year period at a single institution.
  
  
  RESULTS
  Nine patients had a sickle cell-hemoglobin C (SC) profile, 1 was sickle cell-beta(+) thalassemia (S beta(+)-thal), and 4 were sickle cell trait (AS). All 15 eyes underwent pars plana vitrectomy (PPV): 6 for vitreous hemorrhage (VH), 1 for epiretinal membrane (ERM), and an additional 8 for tractional retinal detachment (RD) and/or rhegmatogenous RD. In addition, an encircling scleral buckle (SB) was used in 2 cases. In 7 cases, 20 gauge PPV was used; 23 gauge was used in 3; and 25 gauge was used in 5. All 7 eyes with VH or ERM had improved vision postoperatively. Four of the 8 patients with traction and/or rhegmatogenous RD developed recurrent detachments and required a second operation. All retinas were attached at last follow-up, and visual acuity was 20/400 or better in all eyes. No cases of anterior segment ischemia were encountered.
  
  
  CONCLUSIONS
  Anterior segment ischemia is no longer a common occurrence in eyes undergoing surgery for proliferative sickle retinopathy. Although PPV has replaced the use of SB in many situations, an encircling SB may still be used in this population when necessary. Surgery for VH and ERM generally results in favorable outcomes, but eyes undergoing surgery for traction/rhegmatogenous RD carry a more guarded prognosis.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: r.chen6@med.miami.edu.
authors.forename: Royce W S
authors.initials: RW
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Harry W
authors.initials: HW
authors.lastname: Flynn
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Wen-Hsiang
authors.initials: WH
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: D Wilkin
authors.initials: DW
authors.lastname: Parke
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Ryan F
authors.initials: RF
authors.lastname: Isom
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Davis
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: William E
authors.initials: WE
authors.lastname: Smiddy
mesh_terms: D000328:Adult; D000368:Aged; D019773:Epiretinal Membrane / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005451:Fluorescein Angiography; D006450:Hemoglobin SC Disease / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012163:Retinal Detachment / Q000175:diagnosis / Q000601:surgery; D012164:Retinal Diseases / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D012805:Sickle Cell Trait / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014821:Vitrectomy; D057586:Vitreoretinal Surgery; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000601:surgery; D055815:Young Adult