Abstract
BACKGROUND: Much effort has been exerted to improve the vitreous cutter probe. This study sought to investigate the clinical outcomes of using a novel 25-gauge (25-G), 10,000-cuts-per-minute (cpm) beveled-tip cutter probe (BTCP) to treat complex rhegmatogenous retinal detachment (RRD). METHODS: The preoperative characteristics, intraoperative surgical information, and postoperative recovery data of a prospective case series of 60 consecutive eyes that underwent primary pars plana vitrectomy (PPV) for complex RRD between March and October 2021 were recorded, and the correlations among these factors were examined. RESULTS: A total of 60 patients (25 female) with primary complex RRD were included in the study. Of the 60 eyes, 6 (10.00%) had RRD with a giant retinal tear, 15 (25.00%) had RRD with multiple retinal breaks involving more than one quadrant, 12 (20.00%) had macular holes (MHs), 14 (23.33%) had choroidal detachment, and 32 (53.33%) had proliferative vitreoretinopathy (PVR) grade C. The mean total surgical time was 59.22±14.85 min. Iatrogenic breaks occurred in 15 eyes. The total surgical time was correlated with the severity of PVR (P<0.05). Iatrogenic breaks were more likely to be detected in eyes with severe PVR and those that underwent longer surgical time. During the follow-up period, retinal re-detachment occurred in six eyes, which were re-treated. After a mean follow-up period of 6.31±2.24 months, the retina was attached in all 60 eyes (13 of which still contained silicone oil tamponades). The best-corrected visual acuity (BCVA) improved from the preoperative level in all eyes (P<0.001). The final BCVA appeared to be correlated with the duration of retinal detachment, the preoperative BCVA, macular involvement, and MHs. CONCLUSIONS: The primary results showed that the 25-G, 10,000-cpm BTCP combines the merits of high cutting speed, a large port, and a beveled-tip design, which allows the vitreous to be thoroughly cleared with great efficiency, and which is safe and effective for complex RRD surgery.