Marwan Tahoun, Ahmed Bakr, Abd Alhadi Abou Swid, Amr Tahoun, Rana Tahoun, Adonis El Salloukh
Surgical intervention for RD in Stickler syndrome achieves a high rate of final anatomical success but is marked by a modest primary success rate that is lower than in idiopathic cases. The need for multiple interventions is common, especially in younger patients and those complicated by PVR.
PURPOSE: To systematically evaluate the anatomical and functional outcomes of surgical repair for retinal detachment (RD) in patients with Stickler syndrome, a condition that presents unique and complex surgical challenges due to abnormal vitreoretinal anatomy.
METHODS: A systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of Cochrane, Web of Science, PubMed, EMBASE, and MEDLINE databases was performed up to November 2025 to identify studies reporting outcomes of surgical repair for retinal detachment in patients with Stickler syndrome. Primary outcomes included primary and final reattachment rates and changes in best-corrected visual acuity (BCVA).
RESULTS: Ten multi-eye studies, comprising 217 eyes from 188 patients, were included after the exclusion of single-case reports. The pooled random-effects meta-analysis demonstrated a primary reattachment rate of 0.66 (95% Confidence Interval (CI): 0.50 to 0.78; I² = 65.8%, p = 0.0018; prediction interval 0.21 to 0.93). The pooled final reattachment rate, calculated from ten multi-eye studies (217 eyes), was 0.91 (95% CI: 0.79 to 0.96; I² = 55.5%, p = 0.0165; prediction interval 0.37 to 0.99), often requiring multiple surgeries. Proliferative vitreoretinopathy (PVR) and paediatric age were associated with lower primary reattachment rates. Combined PPV and SB procedures were utilised in multiple studies.
CONCLUSION: Surgical intervention for RD in Stickler syndrome achieves a high rate of final anatomical success but is marked by a modest primary success rate that is lower than in idiopathic cases. The need for multiple interventions is common, especially in younger patients and those complicated by PVR.