Abstract：
OBJECTIVE: Despite recent developments in vitrectomy technology and instrumentation, rhegmatogenous retinal detachment in Stickler syndrome (RDS) remains a challenge for surgeons. RDSs are associated with a higher rate of complications and surgical failures than those not associated with Stickler syndrome. This study is a report about anatomic and visual outcomes of RDS surgery and describes the surgical techniques associated with the treatment of this specific condition.
METHODS: This is a retrospective, interventional, consecutive case series of patients with RDS undergoing retinal reattachment surgery from 1990 to 2020 at the Institute of Ocular Microsurgery (IMO) in Barcelona, Spain.
RESULTS: Twenty-four eyes of 18 patients with genetically confirmed Stickler syndrome were included in the study. Ten eyes (41.6%) presented a giant retinal tear. Retinal reattachment was achieved in all cases after an average of 1.21 (range 1-6) surgical interventions. Nineteen eyes (79%) required only one operation to achieve complete retinal reattachment. The most common first surgical procedure was a 4-mm scleral buckle with posterior pars plana vitrectomy and silicone oil endotamponade, performed on 16 (66.6%) of the eyes. The mean follow-up period was 10.2 years. Mean preoperative visual acuity LogMar was 1.10 (Snellen equivalent 20/252), which improved to 0.50 (Snellen equivalent 20/63) at final follow-up (p < 0.05).
CONCLUSIONS: In most RDS cases, anatomic success and visual acuity improvement can be achieved with the first surgical procedure, using a combination of silicone oil tamponade and a 4-mm scleral encircling band. In some early cases of RDS, other less invasive surgical techniques can be used.
METHODS: This is a retrospective, interventional, consecutive case series of patients with RDS undergoing retinal reattachment surgery from 1990 to 2020 at the Institute of Ocular Microsurgery (IMO) in Barcelona, Spain.
RESULTS: Twenty-four eyes of 18 patients with genetically confirmed Stickler syndrome were included in the study. Ten eyes (41.6%) presented a giant retinal tear. Retinal reattachment was achieved in all cases after an average of 1.21 (range 1-6) surgical interventions. Nineteen eyes (79%) required only one operation to achieve complete retinal reattachment. The most common first surgical procedure was a 4-mm scleral buckle with posterior pars plana vitrectomy and silicone oil endotamponade, performed on 16 (66.6%) of the eyes. The mean follow-up period was 10.2 years. Mean preoperative visual acuity LogMar was 1.10 (Snellen equivalent 20/252), which improved to 0.50 (Snellen equivalent 20/63) at final follow-up (p < 0.05).
CONCLUSIONS: In most RDS cases, anatomic success and visual acuity improvement can be achieved with the first surgical procedure, using a combination of silicone oil tamponade and a 4-mm scleral encircling band. In some early cases of RDS, other less invasive surgical techniques can be used.
摘要：
目的：尽管玻璃体切割术技术和仪器最近有所发展，Stickler综合征（RDS）中的孔源性视网膜脱离仍然是外科医生面临的挑战。与与Stickler综合征无关的患者相比，RDSs与更高的并发症和手术失败率相关。这项研究是关于RDS手术的解剖和视觉结果的报告，并描述了与这种特定疾病治疗相关的手术技术。
方法：这是一个回顾性研究，介入,从1990年到2020年，在巴塞罗那的眼显微外科研究所（IMO）接受视网膜复位手术的RDS患者连续病例系列，西班牙。
结果：研究中纳入了18例基因证实的Stickler综合征患者的24只眼。十只眼睛（41.6％）出现巨大的视网膜撕裂。在平均1.21（范围1-6）的手术干预后，所有病例均实现了视网膜复位。19只眼睛（79％）只需要一次手术即可实现完全的视网膜复位。最常见的首次外科手术是4毫米巩膜带后平坦部玻璃体切除术和硅油内填充。16只(66.6%)的眼睛。平均随访时间为10.2年。术前平均视力LogMar为1.10（相当于Snellen20/252），最终随访时改善至0.50（Snellen当量20/63）（p<0.05）。
结论：在大多数RDS病例中，解剖的成功和视力的改善可以实现与第一次外科手术，使用硅油填充剂和4毫米巩膜环绕带的组合。在一些早期的RDS病例中，可以使用其他侵入性较小的手术技术。
方法：这是一个回顾性研究，介入,从1990年到2020年，在巴塞罗那的眼显微外科研究所（IMO）接受视网膜复位手术的RDS患者连续病例系列，西班牙。
结果：研究中纳入了18例基因证实的Stickler综合征患者的24只眼。十只眼睛（41.6％）出现巨大的视网膜撕裂。在平均1.21（范围1-6）的手术干预后，所有病例均实现了视网膜复位。19只眼睛（79％）只需要一次手术即可实现完全的视网膜复位。最常见的首次外科手术是4毫米巩膜带后平坦部玻璃体切除术和硅油内填充。16只(66.6%)的眼睛。平均随访时间为10.2年。术前平均视力LogMar为1.10（相当于Snellen20/252），最终随访时改善至0.50（Snellen当量20/63）（p<0.05）。
结论：在大多数RDS病例中，解剖的成功和视力的改善可以实现与第一次外科手术，使用硅油填充剂和4毫米巩膜环绕带的组合。在一些早期的RDS病例中，可以使用其他侵入性较小的手术技术。
