Beveled-tip Versus Flat-tip Vitrectomy Probe for Vitreous Cortex Remnants Removal in Vitrectomy for Rhegmatogenous Retinal Detachment

Background and Objective: To compare the efficacy and safety of 25-gauge beveled-tip and flat-tip probes for vitreous cortex remnants (VCR) removal during vitrectomy for rhegmatogenous retinal detachment (RRD). Patients and Methods: Operative videos of 60 eyes with RRD, including VCR, which underwent surgery with a beveled-tip (30 eyes) or a flat-tip vitrectomy probe (30 eyes), were analyzed retrospectively. The main outcome was the extent of the peripheral VCR removal area peeled using only the vitrectomy probe. Secondary endpoints were total vitrectomy time and intraoperative and postoperative complications. Results: The area of peripheral VCR removal was significantly wider in the beveled-tip group than in the flat-tip group (69.8% vs 56.9%, P = 0.039), whereas the total vitrectomy time and time for VCR removal with the vitrectomy probe were not different (51.7 vs 57.4 minutes, P = 0.051; 2.5 vs 3.7 minutes, P = 0.157). Furthermore, none of the eyes required additional surgery for postoperative proliferative vitreoretinopathy or redetachment. Conclusion: VCR removal with a beveled-tip probe during RRD vitrectomy was more extensive than that with a flat-tip probe without adverse effects. This study adds the clinical implication of using a beveled-tip probe in routine practice.